周围型肝内胆管细胞癌的CT表现特征

CT Features of Peripheral Intrahepatic Iholangiocarcinoma(PICC)

目的探讨周围型肝内胆管细胞癌的CT表现特征,提高对周围型胆管细胞癌的认识。方法回顾性分析经手术及穿刺活检病理证实的22例周围型肝内胆管细胞癌的常规CT平扫和CT动态增强扫描资料。结果 22例中18例为单发病灶,4例为多发病灶,总共发现27个病灶,其中15个病灶位于左叶,9个病灶位于右叶,3个病灶同时跨左右叶分布;大小3-15cm不等,平均7.4cm。21例CT扫描平扫为低密度肿块,1例因有脂肪肝,病灶呈稍高密度。肿块呈圆形、分叶状或不规则形。动脉期17例表现为从病灶边缘轻度不均匀强化,1例为边缘明显强化,4例为无明显强化;1例有邻近肝组织过度灌注征象;门脉期22例病灶均呈轻中度强化,呈向心性,病灶内出现不规则条状、片状强化影,延迟扫描病灶仍持续强化,并进一步向中央充填。结论周围型肝内胆管细胞癌CT表现具有一定特征,掌握这些特征,对于诊断和鉴别诊断有着重要价值。

Obejective Investigating CT features in patients with peripheral intrahepatic cholangiocarcinoma,in order to improve the understanding about the distinctive manifestations of peripheral intrahepatic cholangiocarcinoma.Methods 22 cases of PICC underwent CT plain and enhanced scan were analyzed retrospectively which confirmed by pathology through surgery and needle biopsy.Results Single lesion was showed in 18 cases and multiple lesions were found in 4 cases.In the total of 27 lesions,15 were located in the left liver,9 cases in right lobe and 3 cases in both left lobe and right lobe.The sizes of lesions were from 3cm to 15cm with an average of 7.4cm.On plain CT scan,The lesions of 21 cases were shown low-density and the lesion of 1 case was shown slightly high density because of fatty liver.Masses were round,lobulated or irregular shape,On enhanced scan of arterial phase,17 cases were found minimal rim enhancement,1 case was shown sharp rim enhancement,and 4 cases appeared as non-enhangcement;1 case had luxury perfusion in liver tissue around;On enhanced scan of portal phase,All cases were shown mild to moderate enhancement and were manifested centriptally.Irregular linear and patchy enhancement were found inside the lesions..On enhanced scan of delayed phase,The lesions were enhangced continuously and further strengthened to the central filling.Conclusion The CT appearances of peripheral intrahepatic cholangiocarcinoma have it＇s characteristics and were important in the diagnosis and differential diagnosis.