肝内胆管脓肿的CT诊断

CT diagnosis of intrahepatic bile duct abscess

目的 :探讨肝内胆管脓肿的CT诊断和鉴别诊断。方法 :回顾性分析经临床、病理证实的 2 7例肝内胆管脓肿患者的CT表现及临床资料。结果 :2 7例均可见肝脓肿及胆源性病变表现。肝脓肿CT平扫表现为低密度肿块 ,单发圆形(8例 )、多房或簇状 (9例 )或不规则多发 (10例 ) ,增强扫描示脓肿实质部分明显强化 ,呈“肿块缩小征”6例 ,“周围充血征”8例 ,“簇状征”9例 ,“环靶征”仅 4例。胆源性病变CT表现包括胆管扩张、胆管壁增厚并明显强化 ,胆道积气及胆道结石等。结论 :CT扫描可发现肝脓肿及胆道病变 ,是临床诊断肝内胆管脓肿最可靠的影像学方法。

Objective:To evaluate CT features of intrahepatic bile duct abscess (IBDA).Methods:CT findings of 27 cases with IBDA proved by clinic and pathology were retrospectively analyzed.Results:The CT manifestations of IBDA included hepatic abscess and bile duct abnormalities in all of 27cases.The plain CT scanning showed hepatic abscesses as single round hypodensity (8 cases),polycystic or cluster-like lesion (9 cases) or multiple irregular masses (10 cases).Contrast enhanced CT scanning showed marked enhancement of the solid part and revealed mass diminution sign (6 cases), peripheral congestion sign (8 cases),cluster sign (9 cases),ring-target sign (only 4 cases).Abnormalities of bile ducts included cholangiectasis,ducts wall thickening with marked enhancement,biliary calculi and gas collection in the ducts,etc.Conclusion:CT scanning can demonstrate hepatic abscess and abnormalities of bile ducts,it is the most important imaging method for clinical diagnosis of intrahepatic bile duct abscess.