MSCT多期增强扫描诊断肝门区胆管癌15例

Diagnosis of dynamic contrast-enhanced MSCT for hilar cholangiocarcinoma:an analysis of 15 cases

目的:评价MSCT多期动态增强扫描对肝门胆管癌的诊断价值.方法:回顾性分析15例经病理确诊的肝门区胆管癌的临床资料及MSCT图像特征,所有病例均行平扫及四期动态增强扫描(即早动脉期、晚动脉期、门脉期及延迟期).结果:15例肝门胆管癌按CT表现形式分为肿块型、结节型及管壁浸润型,所有病灶均表现为等密度或略低密度.7例肿块型动脉期肿块边缘呈轻度不均匀强化,晚动脉期、门静脉期及延迟期病灶进一步强化;5例结节型多表现为肝门部<2cm的结节,动脉期主要为边缘环状强化,门静脉期及延迟期持续明显强化,且向中心部充填;3例管壁浸润型表现为肝门部胆管壁局限性不规则增厚>2mm,增厚的胆管壁四期扫描均呈明显环状强化,其中2例表现为延迟强化.结论:MSCT四期动态增强扫描对于肝门区胆管细胞癌具有较高的诊断价值.

AIM：To evaluate the diagnostic value of dynamic contrast-enhanced multi-slice spiral computed tomography （MSCT） for hilar cholangiocarcinoma.METHODS：The clinical data and MDCT imaging data of 15 patients with pathologically confirmed hilar cholangiocarcinoma were retrospectively analyzed.All patients underwent plain and four-phase dynamic contrast-enhanced MSCT.RESULTS：According to MSCT findings,15 cases of hilar cholangiocarcinoma were divided into three types：mass-forming,nodular and ductal infiltrating.All cases showed isodensity or hypodensity on plain CT.The imaging characteristics of seven cases of mass-forming hilar cholangiocarcinoma included peripheral uneven enhancement on arterial phase and marked enhancement on late arterial phase and portal venous phase.The imaging characteristics of five cases of nodular hilar cholangiocarcinoma included hilar nodule less than 2 cm,peripheral ring-like enhancement on arterial phase,marked delayed enhancement on portal venous phase and gradual filling of the central area.The imaging characteristics of three cases of ductal infiltrating hilar cholangiocarcinoma included irregular thickening of the bile duct wall by more than 2 mm,and marked ring-like enhancement on arterial and portal venous phase.Two cases of ductal infiltrating hilar cholangiocarcinoma showed delayed enhancement.CONCLUSION：Dynamic contrast-enhanced MSCT is an important diagnostic tool for hilar cholangiocarcinoma.