肝内胆管细胞癌17例CT误诊体会-海南医学.PDFVIP

海南医学2015年8月第26卷第16期 Hainan Med J, Aug. 2015, Vol. 26, No. 16 doi:10.3969/j.issn.1003-6350.2015.16.0863 ·论 著· 肝内胆管细胞癌17例CT误诊体会 何崇保，刘舒琼，黄财富，敬永国 (江油市中医医院放射科，四川 江油 621700) 【摘要】 目的 探讨肝内胆管细胞癌的CT 影像误诊原因，提高其诊断准确率。方法 回顾性分析病理确 诊为肝内胆管细胞癌且CT 误诊的17例患者的影像资料，观察病变位置、形态、强化方式及伴随征象并联合临床 表现及实验室检查结果进行分析。结果 9 例误诊为肝细胞癌，3 例误诊为胆总管囊肿或结石伴胆管扩张，3 例 误诊为肝脓肿，1例误诊为肝血管瘤，1例误诊为肝转移瘤。导致误诊的原因主要有：未做延迟扫描致病灶强化方 式及特点不明确、影像诊断医师观察不仔细致遗漏一些关键影像表现、合并其他肝脏基础疾病致影像表现复杂 等。结论 肝内胆管细胞癌CT 诊断误诊率较高，但其CT 表现仍具有一定的特征性。 【关键词】 电子计算机体层摄影；肝内胆管细胞癌；误诊 【中图分类号】 R735.7 【文献标识码】A 【文章编号】 1003—6350（2015 ）16—2394—03 Misdiagnosisexperiencein17casesofintrahepaticcholangiocarcinomaCT. HEChong-bao,LIUShu-qiong, HUANGCai-fu,JINGYong-guo.DepartmentofRadiology,TheChineseMedicineHospitalofJiangyouCity,Jiangyou, Sichuan,CHINA 【Abstract】 Objective To investigate the reason of the misdiagnosis in the CT imaging of intrahepatic chol- angiocarcinoma to improve the diagnostic accuracy. Methods Seventeen patients diagnozed as intrahepatic cholan- giocarcinoma by pathology and misdiagnosed by CT were retrospectively analyzed. The location, shape, strengthening manner and accompanied signs of lesion and joint clinical manifestations and laboratory test results were analyzed. Results Nine patients were misdiagnosed as hepatocellular carcinoma, and 3 were misdiagnosed as choledochal cyst or stone and bile duct dilation, with 3 as liver abscess, 1 as liver blood vessels aneurysm, and 1 as liver metastases. The main causes of misdiagnosis were as follows: unclear lesion enhancement and characters due to not performing delayed scan, negligence of radiologists, and complex imaging manifestations due to complication with oth