黄色肉芽肿性胆囊炎的CT表现

CT features of xanthogranulomatous cholecystitis

目的探讨CT对黄色肉芽肿性胆囊炎的诊断价值。方法回顾性分析4例经手术病理证实的黄色肉芽肿性胆囊炎的CT表现,分析其影像学特点。结果术前1例确诊,3例误诊。3例胆囊有不同程度的增大,4例胆囊壁均有增厚,壁厚在4～30mm之间,内均可见形态不规则的低密度灶。2例黏膜线完整,其中1例胆囊颈结石嵌顿,1例胆总管结石,1例胆囊内积气合并肝脏浸润。增强后动脉期的“夹心饼干征”2例,环形强化1例。结论增强后动脉期的“夹心饼干征”和环形强化,对黄色肉芽肿性胆囊炎的诊断有重要价值。

Objective To investigate the diagnostic values of CT in xanthogranulomatous cholecystitis （XGC）. Methods Retrospective analysis was performed in 4 patients with pathology confirmed XGC. Abdomen CT scans with and without contrast enhancement were performed in all patients, Results Only lcase was correctly diagnosed before surgery. CT findings included gallbladder enlargement （3 patients）, gallbladder wall thickening （ 4 patients）, gallstone （1 patient）, and common bile duct stone （ 1 patient）. The maximum wall thickness was between 4 mm and 30 mm, with irregular low-density layer inside. Mucosal line was normal in 2 and pericholecystic infiltration in 1. After contrast administration, hypodense band sign was revealed in 2 and rim enhancement sign around the nodules was shown in 1 at arterial phase. Conclusion CT features of hypodense band sign and rim enhancement sign around the nodules in the arterial phase of contrast enhanced CT are strongly suggestive of XGC.