周围型肝内胆管细胞癌CT征象分析-实用中西医结合临床.DOCVIP

周围型肝内胆管细胞癌CT征象分析 谢人永 （南平市人民医院医学影像科 南平353000） 摘要：目的：研究肝脏周围型胆管细胞癌直接及间接影像表现，把握其鉴别诊断要点。方法：对已经病理确诊的31例病例进行剖析、回顾。结果：病灶有23例在左肝叶，右肝叶仅8例。单独病灶26例，5例多个病灶，23例有肝内胆道扩张及肝内胆管含有结石17例，肝叶萎缩变形及局部肝轮廓凹陷21例。病灶大小为1.5~12 cm，平均为6.5 cm。平扫所有病灶均为低密度，平均CT值为43 HU。增强扫描动脉期大多数病例周边不均匀、线样强化，静脉期及实质期进一步强化，平均CT值分别为61 HU、72HU，79 HU。7 min延时扫描增加平均CT值约85 Hu。结论：周围型肝内胆管细胞癌CT影像表现最特征的是缓慢、延时强化，描绘出时间-曲线呈缓慢上升型具有一定特异性，间接影像表现中较特别的是病灶周围或远端胆管显示扩张和包膜凹陷。 关键词：肝脏；胆管细胞癌；MDCT技术；病理基础 Analysis of CT signs in Patients with Peripheral Intrahepatic Cholangio-Carcinoma XIE Ren-yong (Department of Medical Imaging, Nanping Peoples Hospital, NanPing, Fujian353000) Abstract: Objective: To analysis the direct and indirect CT signs in patients with peripheral intrahepatic cholangio-carcinoma (IHPCC) and grasp the main points of differential diagnosis. Methods: Of the 31 cases had been confirmed by pathology analysis, review analyzed. Results: There were 23 cases of lesions in the left hepatic lobe, only 8 cases in right lobe. Single lesion was showed in 26 cases and multiple lesions was found in 5 cases with different sizes, intrahepatic biliary dilatation noted was found in 23 cases, Hepatolithiasis demonstrated was found in 17 cases, lobe atrophy of deformation and local contour sag was found in 21 cases. The sizes of the lesions were 1.5~12 cm, with an average of 6.5 cm. All lesions were showed low-density on CT plain scan with the average CT value of 43 HU. Most cases of peripheral arterial uneven line sample reinforcement, venous phase and further strengthen the essence. The average CT value was 61 HU, 72 HU and 79 HU separately. Delay 7 minutes to strengthen the average CT value of about 85 HU. Conclusion: The typical signs direct CT of peripheral intrahepatic cholangio-carcinoma is delayed enhancement of the lesion, the slow-increase time-density curves of the lesion enhancement is a characteristic feature. Dilatation of the bile duct around lesions and localized excavation of liver contour are of important indirect signs. Ke