Caroli病的64排螺旋CT诊断

64-slice spiral CT in the diagnosis of Caroli disease

目的探讨Caroli病的64排螺旋CT表现及诊断价值。方法对经手术病理证实的15例Caroli病的64排螺旋CT影像资料进行回顾性分析。结果所有病例CT均表现为肝内多发囊状或条状低密度影,与肝内胆管相通,增强扫描无强化,其中4例可见"中心圆点征"。Caroli病Ⅰ型12例,其中2例合并肝内多发血管瘤及肝内多发小囊肿,4例在扩张的胆管内见结石并3例见有胆管积气,1例合并胆管炎改变,其余5例仅发现肝内胆管扩张。Caroli病Ⅱ型3例,其中2例伴有肝硬化;1例合并肝内小胆管炎及门静脉周围纤维化。结论 64排螺旋CT三维重建的应用,可以多方位、多角度全面观察肝内多发囊性病变的分布及与肝内胆管分支的关系,对Caroli病的诊断、鉴别诊断及明确病变范围有重要价值。

Objective To investigate the value of 64-slice spiral CT in the diagnosis of Caroli disease. Methods 64-slice spiral CT of 15 patients with histologically proven Caroli disease was reviewed. Results All cases were polycystic or multi-tubular hypodensities in the livers communicating with intrahepatic bile ducts. There was no contrast enhancement. The central dot sign was detected on 2 patients. Of 12 patients with type I disease, ancillary findings included multiple hemangiomas and small cysts in the liver （2）, bile duct stones （4）, pneumobilia （3）, and cholangitis （1）. Of the remaining 3 patients with type II disease, two had liver cirrhosis and the other cholangitis with periportal fibrosis. Conclusion 64 slice spiral CT with muhiplanar reconstruction allows clear depiction of cystic liver lesions and their relationship with intrahepatic bile ducts. It is valuable in the diagnosis of Caroli disease.