肝门部胆管癌的多层螺旋CT诊断

Multi-slice Spiral CT Diagnosis of Biliary Duct Carcinoma in Porta Hepatis

目的:评价MSCT对肝门部胆管癌的诊断价值。方法:回顾性分析17例行MSCT平扫及动态增强扫描的肝门部胆管癌影像学资料,并与手术及病理对照分析。结果:全部病例均有肝内外胆管扩张,肝内胆管扩张呈软藤状。胆管内肿块(5例),胆管壁局限增厚和管腔狭窄(12例),平扫均为等密度。增强扫描3例强化,14例延迟强化。结论:胆管壁局限增厚、胆管内肿块是肝门部胆管癌的较特征性CT征象,MSCT扫描结合薄层三维重建对诊断具有重要意义。

Objectlve：To assess the value of multi-slice spiral CT （MSCT） in the diagnosis of biliary duct carcinoma in porta-hepatis. Methods： 17 patients with biliary duct cancer in porta-hepatis underwent plain and dynamic enhanced MSCT. CT findings were retrospectively analyzed and correlated with that of surgery and pathology. Results： Intra- and extra-hepatic cholangiectasis were shown in all cases. Rattan-like intra-hepatic bile duct dilatation were found. There were intra-ductal mass lesion （n= 5） and focal thickening of ductal wall as well as narrowing of bile duct （n= 12）. Iso density was shown on plain CT. After contrast administration,enhancement （3 cases） and delayed enhancement （14 cases） could be assessed. Conclusion：Focal thickening of biliary duct wall as well as intra-ductal mass are characteristic findings, and MSCT with 3-D reconstruction provide significant information in the diagnosis of bile duct carcinoma in portahepatis.