胆囊腺肌增生症的CT诊断

CT performance of adenomyomatosis of the gallbaldder

目的通过分析胆囊腺肌增生症的CT表现,探讨CT的诊断价值。方法回顾性分析本院经手术病理证实的11例胆囊腺肌增生症的CT表现。其中8例行CT平扫及多期增强扫描,3例仅行CT平扫。结果术前CT正确诊断8例,其中6例不同程度显示罗-阿氏窦。CT表现:胆囊壁弥漫性或局限性增厚,部分囊腔外侧面毛糙,增强后动脉期病变区黏膜及部分黏膜下层明显强化,门脉期及延迟期强化逐渐向粘膜下肌层及浆膜层扩展,呈均匀或不均匀强化,部分增厚的胆囊壁内见大小不等且无强化的罗-阿氏窦,此为本病的特征性CT征象。结论 CT对胆囊腺肌增生症有较高的诊断价值,尤其是胆囊壁内有罗-阿氏窦显示时可作为定性诊断。

Objective To discuss the CT features of adenomyomatosis of the gallbladder （ADM） in order to evaluate the value. Methods We retrospectively analysed the CT features of eleven cases with ADM which were verified by surgery and pathology in our hospital. 8 cases were performed by CT plain and many phase enhancement scanning, while 3 cases just by plain scanning. Results 8 cases were correctly diagnosed by CT before surgery, in which 6 cases displayed the Ro- kitansky-Aschoff sinuses. CT features were segmental or diffuse gallbladder wall thicken, partly coarse outside of the wall. After the arterial phase enhancement scanning, lesion area of mucosa and suhmucosa was significantly strengthened, portal venous phase and delayed phase of aggrandizement gradually to the submucous muscular layer and serous extracap- sular extension, showed homogeneous or inhomogeneous enhancement, thickened portions in the wall of the cyst size and no enhanced noise of R-A sinuse was seen, which was the characteric CT feature for this disease. Conclusion CT scanning may play an important role in diagnosis of ADM, R-A sinuses were displayed as the typical signs for diagnosis.