胆囊癌的CT诊断及误诊分析

CT Diagnosis of Gallbladder Carcinoma and Analysis of Misdiagnosis

目的:总结胆囊癌的CT表现和诊断,探讨CT误诊原因,以提高对该病的CT认识和诊断水平。方法:收集经手术病理证实的23例胆囊癌病例,回顾分析其术前CT影像表现特征并分析其误诊原因。结果:胆囊癌CT直接征象有肿块10例、结节7例、胆囊壁肥厚6例,病灶均明显强化,伴有胆囊黏膜破坏、囊壁僵硬;同时合并胆囊结石16例、邻近侵犯15例、肝脏转移5例、淋巴结转移11例、胆道梗阻8例及腹水2例。术前CT误诊4例,表现为胆囊癌原发灶恶性征象不典型或外侵转移征象突出。结论:胆囊癌CT直接征象有其特征性,结合常见的间接征象多能作出正确诊断。表现不典型、征象认识不足是误诊的主要原因。

Purpose：To summarize the CT manifestations and investigate the reasons of misdiagnosis of Gallbladder Carcinoma,in order to improve the diagnosis：accuracy of the disease by CT.Methods：Retrospective analysis was performed on preoperative CT imaging data,reasons of misdiagnosis of 23 cases of pathologically proven gallbladder cancer were analyzed.Results：Signs of gallbladder cancer on CT： Direct signs included mass in gallbladder area（10）,intraluminal nodules（7）,irregular thickening of the gallbladder wall（6）,lesion with marked enhancement and destruction of gallbladder mucosa.Concomitant gallbiadder stones（16）,neighboring violations（15）,liver metastasis（5）,lymph node metastasis（11）,biliary obstruction（8）,ascites（2）.In preoperative CT misdiagnosis cases（4）,gallbladder showed atypical malignant signs of primary lesions or atypical signs of invasive metastasis.Conclusion：Features of gallbladder cancer on CT have some characteristics.Integrate with common indirect signs will help to make the correct diagnosis.