肝内胆管细胞癌的MSCT诊断和鉴别

Diagnosis and differentiation of intrahepatic cholangio-carcinoma by MSCT

目的提高对肝内胆管细胞癌(ICC)CT表现的认识和术前诊断准确率。方法收集2002-2010年14例经病理证实的ICC术前CT进行回顾性分析。结果 ICC平扫CT表现为低密度肿块或胆管扩张影,9例位于周围,4例为多发病灶,2例病灶周围见环形低密度影,11例病灶远端胆管扩张,2例临近肝缘萎陷,2例合并门静脉癌栓或淋巴结转移。增强扫描动脉期9例病灶不同程度强化,边缘强化为主,静脉期增加至11例,延迟期所有病灶均强化,呈渐进性向心性强化。本科室术前正确诊断ICC11例,诊断可靠率约78%。结论 MSCT三期增强检查可作为诊断ICC的重要手段。

Objective To improve the diagnosis of intrahepatic cholangio-carcinoma（ICC） before the surgical pathology by multislice computed tomography（MSCT）.Methods MSCT images of 14 patients with intrahepatic cholangio-carcinoma confirmed by pathology were retrospectivelly analyzed.Results The hypodense areas were found in all patients with plain CT scanning,which with peripheral ICC in 9 cases,multiple lesions in 4 cases and a ring enhancement in 2 cases.Distal bile duct dialation were in 11 cases.The adjcent liver tissue atrophy was found in 2 cases.Complicated cancer embolus of portal vein were found in 2 cases.The metastasis of lymph nodes were in 2 cases.By contrast CT scanning,enhanced lesion border of different extent were revealed in 9 cases in arterial phase.11 cases of lesions enhancement in venous phase.Of all the 14 cases,gradual concentric enhancement of the lesions were displayed in delayed phase.11 cases of all patients were recognized as the ICC according to the CT features before surgical pathology.The diagnostic accuracy was 78%.Conclusion MSCT has a higher diagnostic accuracy and so can be applied as an important approach for the ICC.