口服胆囊造影CT诊断胆囊隆起性病变

Diagnosis of Elevated Gallbladder Lesions with Oral Cholecystographic CT

目的：探讨口服碘番酸胆囊造影ＣＴ（简称ＯＣＣＴ）对良恶性胆囊隆起性病变的诊断作用。材料与方法：分析３８例手术病理证实的胆囊隆起性病变（胆固醇息肉２８例，腺瘤样息肉３例，乳头状瘤１例，腔内型胆囊癌５例和腺瘤恶变１例）的ＯＣＣＴ表现。结果：胆固醇息肉表现为胆囊内多发或单发性颗粒状充盈缺损，直径均≤０．５ｃｍ；腺瘤样息肉和乳头状腺瘤均呈单发结节，直径为０．５５～０．８ｃｍ；腺瘤恶变和腔内型胆囊癌均为体积较大的结节，直径≥１．２ｃｍ。结论：ＯＣＣＴ是诊断胆囊隆起性病变的有效方法之一；病变大小是鉴别良恶性胆囊隆起性病变的有力依据。

Objective: To evaluate the value of cholecystographic CT (OCCT), by using iopanoic acid administered orally, in differentiating benign lesion from malignant lesion in the gallbladder.Materials and Methods:38 patients with pathologically proved elevated gallbladder lesions were studied. Of 38 patients, 28 had cholesterol polyps, 3 had adenomatoid ployps, 1 had papiloma, 5 had carcinoma of gallbladder and 1 underwent malignant process of adenoma. Their OCCT features were analysed retrospectively.Results:Cholesterol polyps were manifested as multiple or single granular filling defects in the gallbladder, varied from 0.1～0.5cm in diameter. Both adenomatoid polyps and papiloma took the form of singular nodule, measuring 0.55～0.8cm in diameter. By contrast, all malignant lesions were characterized as large nodules (≥1.2cm in diameter).Conclusion: These results suggest that OCCT is an effective approach for diagnosing of elevated lesions in the gallbladder. The lesion size is a helpful criterion in differentiating benign lesions from malignant lesions.