MSCT在肝内周围型胆管细胞癌诊断中的价值

Value of multi-slice spiral CT in diagnosis of intrahepatic peripheral cholangiocarcinoma

目的:探讨MSCT在肝内周围型胆管细胞癌诊断中的价值。方法:回顾性分析经手术及/或病理证实的28例原发性肝内胆管细胞癌的MSCT表现。所有病例均作平扫及三期增强扫描,19例作延迟扫描;22例作多平面重建。结果:肿块型24例,浸润狭窄型3例,腔内生长型1例。平扫多呈低密度,边缘不清。增强扫描动脉期多呈轻至中度周边强化或网格样强化,门静期及平衡期强化逐渐明显并向病灶内部延伸,12例病灶中央出现延迟强化。相邻肝脏局限性萎缩或肝包膜凹陷11例。合并肝内胆管扩张21例,结石6例,肝门及/或腹膜后淋巴结转移7例。本组定位诊断准确率为100%,定性诊断准确率为78.6%。结论:MSCT多期增强扫描,轴位结合多平面重建对周围胆管细胞癌的诊断具有重要价值,对临床治疗有指导作用。

Objective：To investigate the value of multi-slice spiral CT （MSCT） in diagnosis of intrahepatic peripheral cholangioearcinoma （IHPCC）. Methods：28 cases of MSCT images of IHPCC proved by surgery and/or pathology were retrospectively analyzed. Both plain and MSCT three-phase enhancemeut scan were performed in all cases, delayed scan were made in 19 eases and multiplanar reconstructions （MPR） were made in 22 cases. Results：Mass-type 24 cases,infiltrative-type 3 cases, and intracavitary-type 1 case. On plain scan, the tumor were mainly low density and edges unclearly. And appeared mainly mild-moderate enhancement around the periphery of the tumor on arterial phase. The enhancement were upgrade by degree and extended toward interior of the tumor on portal vein phase and equilibrium phase. On delay phase, the center of tumor appeared enhancement in 12 cases, regional liver atrophy or capsule retraction 11 cases. The lesions combined with intrahepafie eholangiectasis 21 cases, calculus of intrahepafie duct 6 cases, hepafie portal and/or retreperitoneal lymph node metastasis 7 cases. The accuracy rate of MSCT diagnosis for location and pathologic features of IHPCC were 100% and 78.6 %. Conclusion： Mulfiplanar phase MSCT examination, axial images combined with MPR images have important value for diagnosis of IHPCC and is helpful for treatment planning.