胆管囊腺癌的MRI表现与病理的对照分析

Bile cystadenocarcinoma:MRI findings with pathologic correlation

目的探讨 MRI 诊断胆管囊腺癌(BCAC)的价值。方法回顾性分析5例经手术病理证实的 BCAC 患者的 MRI 表现,并与病理所见对照。结果 4例单发,1例多发。5例均为囊实性肿物,2例单房、3例多房,囊内可见多个大小不等的壁结节及厚薄不均的间隔。液性部分呈均匀的长T_1、长 T_2信号,实性部分呈稍长 T_1、稍长 T_2信号。注射钆喷替酸葡甲胺(Gd-DTPA)后,囊性部分无强化,实性部分动脉期轻度强化、门静脉期及延迟期呈中度至明显强化。MRI 表现与病理所见对应良好。术前4例诊断为囊腺瘤或囊腺癌,1例诊断为胆管癌。结论 MRI 能显示 BCAC 的特征性表现,可以做到术前正确诊断。

Objective To describe the MRI features and pathologic findings of biliary cystadenocarcinoma （BCAC） and to assess the diagnostic value of MRI in those tumors. Methods Five cases of BCAC were collected. An cases were proved by pathology. Non-enhanced and muhiphase-enhanced MRI were performed in all cases. MRCP were performed in two cases. The MRI features of the five cases were reviewed retrospectively and correlated with pathologic findings. Results Histological evidence demonstrated five cases of BCAC. Four cases were solitary, whereas the other case was multifocal. All cases were solid and cystic lesions. Two cases were unilocular, whereas the other three cases were multilocular. Multiple mural nodules and irregular thickening cystic walls were presented in all cases. The cystic parts of the lesions were homogeneous in signal intensity and showed no enhancement after contrast administration in the five BCAC. Septa were present in three BCAC with multilocular cyst. On MRCP the bile duct dilatation was found in two BCAC. Conclusion MRI can reveal the characteristic findings of BCAC and accurate preoperative diagnosis can be made.