肝内胆管细胞癌的CT诊断及其鉴别诊断

Diagnosis and Differential Diagnosis of Intrahepatic Cholangiocellular Carcinoma Via CT

目的探讨CT对肝内胆管细胞癌的诊断及其与肝内其他肿瘤的鉴别要点分析。方法回顾性分析我院近年来经CT诊断手术病理证实的12例肝内胆管细胞癌的CT资料,重点分析其平扫及增强扫描的CT表现。结果 12例患者中,11例为单发病灶,大小为4~11cm,1例肝内多发大小不等的病灶,伴肝内胆管扩张的8例,局部肝包膜内陷的5例,肝内胆管结石2例,肝门区及腹膜后大血管旁淋巴结肿大3例,门静脉癌栓1例;增强扫描动脉期病灶呈边缘轻度不均匀强化,静脉期及延时扫描病灶进一步强化,呈＂延迟强化＂。结论肝内胆管细胞癌的CT表现有一定的特征性,应仔细观察各种征象,动态增强特征性为渐进性强化,病灶内部的分隔状强化,能与大多数肝内其他肿瘤相鉴别。

Objective This study is to discuss the diagnosis of intrahepatic cholangiocellular carcinoma and the differentiation between such diagnosis and other liver tumors.Methods In this research,CT data of 12 intrahepatic cholangiocellular carcinoma cases which are confirmed by operation and pathology in recent years are analyzed with an emphasized analysis on CT performance when conducting plan CT scan and enhancement scan.Results Among the 12 patients,11 are single lesion（size： 4-11cm）;1 is intrahepatic multiple sizes lesion;8 are with intrahepatic biliary cysts;1 with portal vein tumor thrombus.Enhancement scanning arterial lesion shows mild uneven edge enhancement and venous delayed scanning lesion further enhanced,which shows delayed enhancement.Conclusion This study is that CT performance of intrahepatic cholangiocellular carcinoma has certain features,which requires careful observation of all symbols.Meanwhile,the feature of dynamic enhancement is gradualism,centrality enhancement,lesion internal flake,grid and linear enhancement can be differentiated from most of other liver tumors.