原发性胆囊癌与慢性化脓性胆囊炎的CT鉴别诊断

Gallbladder Carcinoma and Chronic Cholecystitis on CT

目的:探讨原发性胆囊与慢性化脓性胆囊炎的CT诊断及鉴别诊断。材料与方法:回顾性分析29例胆囊癌及12例慢性化脓性胆囊炎的临床表现及CT资料。结果:两组病例临床表现类似。CT显示胆囊癌的胆囊壁增厚6例,突入胆囊腔内肿块16例及肿块占据整个肿囊7例。肝内胆管扩张18例。病灶均有轻度至中度强化。慢性胆囊炎均表现胆囊增大,壁增厚;5例壁内存在低密度区;增强后明显强化。肝内胆管扩张1例。结论:CT显示胆囊癌主要表现为局部肿块及肝内胆管扩张;胆囊炎表现为胆囊壁增厚、边缘模糊,尤其CT可以发现壁内低密度小脓肿。

Purpose: To evaluate the diagnosis and the different diagnosis between primary gallbladder carcinoma (group A) and chronic cholecystitis (group B) on CT. Materials and Methods; The clinical data and CT findings of 29 cases with primary gallbladder carcinoma and 12 cases with chronic cholecystitis in clinic and on CT were reviewed in 29 cases and 12 cases. Results; Clinical appearances in two different groups were similar. On CT in A group, the thickness of the gallbladder wall increased in 6 cases, there were masses in the cavity of the gallbladder in 16 cases, and the mass occupied the gallbladder in 7 cases. The dilation of intrahepatic bill ducts was found in 18 cases. The lesions were enhanced on postcontrast CT in all cases. In B group, gallbladder enlarged, and thickness of it's wall increased. Hypodense areas were found within the wall in 5 cases and remarkably enhancement were showed in all on postcontrast CT. Dilaeation of intrahepatic bill ducts was found in 1 cases. Conclusion; On CT, the main findings were mass and diltation of intrahepatic bill ducts group A, Unclear and thicken wall, especially hypodense areas in the wall, were found in group B.