黄色肉芽肿性胆囊炎的影像学表现

Imaging characteristics of xanthogranulomatous cholecystitis

目的探讨黄色肉芽肿性胆囊炎的影像学表现及其病理基础。方法分析经病理证实的16例黄色肉芽肿性胆囊炎的CT、MR表现。观察胆囊壁厚度、胆囊壁强化情况、胆囊壁内结节、胆囊内黏膜线、胆囊内有无结石以及胆囊周围的变化。结果16例患者中胆囊增大12例、缩小4例,所有患者均见不同程度的胆囊壁增厚及胆囊壁内结节,6例胆囊内显示黏膜线。11例患者胆囊内有结石。胆囊周围炎性浸润8例,其中2例炎症侵及肝脏。结论胆囊壁增厚、增厚胆囊壁内结节及胆囊内黏膜线是诊断黄色肉芽肿性胆囊炎的特征性表现。

Objective To analyses the hnaging characteristics of xanthogranulomatous cholecystitis （XGC） and to correlate these features with the pathology. Methods Retrospective analysis was performed in 16 pathologically proved cases of XGC. The following Imaging features were analyzed： gallbladder wall thickness, intramural hypo attenuated nodules, mucosal line, the presence of stones and the changes outside the gallbladder. Results The gallbladder walls were thickened and intramural hypo attenuated nodules which were pathologically proved to be xanthogranulomatous nodules were seen in all patients. The enhancement of thickened wall was mild or moderate when contrast material was used. The mucosal line was observed in 6 patients, the size of gallbladder was enlarged in 12 while 4 gallbladders were smaller than normal. Stone were found in 11 gallbladders. The changes outside the gallbladder occurred in 8 patients including hepatic involvement in 2 patients. Conclusions The Imaging characteristics of thickened gallbladder wall with intramural hypo attenuated nodules and mucosal lines are strongly suggestive of XGC.