周围型肝内胆管细胞癌的影像学表现

Imaging findings of intrahepatic peripheral cholangiocarcinoma

目的 探讨周围型肝内胆管细胞癌的影像学特征。方法 回顾性分析经手术及病理证实的 11例周围型肝内胆管细胞癌的影像学资料。术前均行超声扫描 (BUS)。 11例中 ,8例行CT扫描 ,其中 4例为先平扫后增强 ,2例行动态双期扫描 ,另 2例先动态后延迟扫描。 11例中有 3例行MRI扫描 ,常规SE序列 ,T1加权相 (T1WI)和T2加权相 (T2WI) ,其中 1例行动态扫描。结果 超声扫描所有病灶均呈低回声 ,均匀或不均匀。CT平扫病灶呈低密度 ,边界不清 ,增强扫描呈边缘中等强度强化。MRI表现为T1WI低信号 ,T2WI较高信号。动态MRI及双期CT ,病灶表现为特征性的从周边到中心的向心性强化。病灶周围肝内胆管轻度扩张 ,局部肝被膜回缩明显。结论 周围型肝内胆管细胞癌的影像学表现具有一定的特征性 。

Objective To study the imaging features of intrahepatic peripheral cholangiocarcinoma.Methods The imaging features of 11 cases of surgically and pathologically confirmed intrahepatic peripheral cholangiocarcinoma were retrospectively reviewed. B ultrasonic scanning(BUS) was performed in all patients. CT was done in 8 patients, including conventional unenhanced scanning followed by enhanced scanning in 4 patients, dynamic double stage scanning in 2 patients, and dynamic double stage scanning followed by delayed scanning in the other 2 patients. Of the 3 patients received MRI, conventional SE series,T1WI and T2WI were performed in 2 patients, conventional SE series and dynamic scanning in the other one.Results All lesions were hypo echoic in BUS, homogeneous or heterogeneous.On unenhanced CT,the lesions were of low density with ill defined border. On enhanced scanning,moderate enhancement was observed at the edge of the lesions.MRI was of low intensity in T1WI and moderately high intensity in T2WI. Dynamic MRI and double stage CT scanning showed characteristic enhancement from the periphery toward the center of the lesion. Focal dilatation of the intrahepatic bile ducts around the tumor was seen in 6 cases and retraction of liver capsule in 3 cases.Conclusion To some extent, the imaging features of intrahepatic peripheral cholangiocarcinoma are characteristic. They are useful for differentiating these tumors from other space occupying lesions in the liver.