肝胆管囊腺瘤2例CT及MRI表现

CT and MR characteristics of cystadenoma of biliary duct: 2 cases report

目的:探讨肝胆管囊腺瘤CT及MRI影像学表现及病理特点,评价CT及MRI对其诊断价值。方法:回顾分析2例手术病理证实的肝胆管囊腺瘤的CT及MRI表现,并作文献复习。2例患者均行CT及MRI平扫及MRI动态强化。结果:CT平扫2例均为巨大类园形囊性低密度影,囊内密度较均匀,囊内可见线状分隔;MRI平扫病灶呈长T1长T2信号,1例部分囊腔呈T1信号改变,囊壁及分隔光滑、均一,MRI增强扫描见囊内分隔及囊壁早期轻度强化,静脉期信号进一步增高,延迟期信号仍高于肝实质,未见乳头状突起及壁结节征象。结论:肝内囊腺瘤少见,常因误诊导致治疗延迟,CT及MRI能显示囊腺瘤的一些特征,尤其MRI能清晰显示囊壁、分隔的情况及囊液成分,有助于该病的诊断及鉴别诊断。

Objective： To study the pathology, CT and MRI characteristics of cystadenoma of biliary duct, evaluate the CT and MRI diagnosis of cystadenoma of biliary duct. Methods： Clinical, CT and MRI data of two patients with cystadenoma of biliary duct confirmed by pathology and surgery were studied retrospectively. Both patients were undergone noncontrast CT and MRI and dynamic contrast enhanced MRI examinations. Results： On noncontrast CT, manifestations of lesions of the two cases were huge quasi - circular with thread - like septa, homogenous low density ; On noncontrast MRI, manifestations of the lesions of the two cases were long T1 and long T2 signals dominantly , part lesion in one case with slight short T1 signal, wall and septa of the cystademas were smooth and homogenous. On contrast enhanced MRI, signals of septa and wall of the cystademas were enhanced slightly in early phase, which became stronger in venous phase , and they were still higher than that of liver parenchyma in delayed phase. Undetected papillary protrude and nodular lesion. Conclusion： Cystadenoma of biliary duct is a rare disease, it frequently cant be treated timely because of misdiagnosis. CT and MRI can find some fea- tures of it, especially MRI can detect the wall, septa and the component of cystadenoma clearly, and thus conducive to diagnosis.