动态螺旋CT对肝内胆管细胞癌的诊断价值探讨

Value of dynamic multiphasic spiral CT in diagnosis of intrahepatic cholangiocarcinoma

目的：分析肝内胆管细胞癌的ＣＴ表现，评价螺旋ＣＴ多期扫描的诊断价值。方法：对１２例疑为肝内胆管细胞癌的患者进行了ＣＴ平扫及螺旋动态多期扫描，分析总结了其ＣＴ表现，并与原发性肝癌及血管瘤作了鉴别诊断。结果：主要的ＣＴ表现有：①平扫，边缘欠清的低密度病灶中可有单发或多发的高密度钙化影；②增强扫描，动脉期与静脉期无强化或轻度强化，但明显低于正常肝实质的强化；③延迟扫描，随着时间的延长病灶逐步强化，且由边缘向中央进行，最后病灶强化高于正常肝实质，部分中央无强化，延迟扫描的表现有重要诊断意义；④病灶的周围可见扩张的肝内胆管。全部病例均经手术病理证实。结论：螺旋ＣＴ动态多期扫描对肝内胆管细胞癌的诊断有非常重要的应用价值。

Objective:To describe CT features and assess the value of dynamic multiphasic spiral CT in evaluating intrahepatic cholangiocarcinoma （ICC）.Methods:12 cases of suspicious ICC underwent dynamic multiphasic spiral CT.CT features were analyzed and differential diagnosis were discussed.Results:The main CT features were:1.low density lesion with spot like calcification and ill-defined margin on plain scan;2.mild enhancement of the lesion in arterial phase and portal-venous phase;3.in delayed scan there was progressive enhancement from periphery to center,but some of lesions had no or only mild enhancement in the center.At last the density of the lesion was higher than that of normal liver,and this was a very important diagnostic sign;4.cholangiectasis around the lesion.All cases were confirmed by operation and pathology.Conclusion:Dynamic multiphasic spiral CT scan if of great value in diagnosis of ICC.