肝内胆管细胞癌的CT诊断

CT diagnosis of intrahepatic cholangiocellular carcinoma

目的探讨肝内胆管细胞癌的CT增强特征及其病理基础,提高该病CT诊断的准确性。方法15例经病理证实的肝内胆管细胞癌,均行CT平扫及增强扫描,其中,6例加做CT延时扫描。结果15例平扫表现为低密度病灶伴肝内胆管扩张8例,合并肝内胆管结石4例,合并钙化2例;增强扫描呈线样强化7例,呈网格样强化6例,结节样强化1例,无明显强化1例;病理显示肝内胆管细胞癌纤维组织丰富,血管稀少。结论CT平扫病灶呈低密度而增强扫描呈线样及网格样强化对肝内胆管细胞癌的诊断及鉴别诊断有重要意义。

Objective To discuss the CT features of intrahepatic cholangiocellular carcinoma （IHCC）and their pathologic fundation so as to elevate the recognition of this disease. Methods Fifteen patients with pathologically proved IHCC underwent CT seans of the abdomen without and with contrast enhancement, of them, six patients underv, ent additional delayed seans. Results On CT images without contrast enhancement of 15 cases, the lesions presented hypodense associated with intrahepatic bile dud dilatation（8）, associated with intrahepatic bile duct lithiasis（4）, and associated with calcification（2）. On CT images with contrast enhancedment of 15 cases, the lesions were fine - linear enhancement（7）, network - form enhancement（6）, nodular enhancement（1）, and invisible enhancement（1） . IHCC pathologically shown rich fibrous tissue and rarefactive blood vessels. Conclusion Hypodense on CT images before enhancement and fine - linear - or network form enhancement after enhancement scans are specifc findings of IHCC and these are helpful to diagnose and differentiate this discase.