黄色肉芽肿性胆囊炎的影像学诊断(附5例报告)

Imaging diagnosis of xanthogranulomatous cholecystitis (report of 5 cases)

目的探讨黄色肉芽肿性胆囊炎(XGC)的影像诊断。方法回顾性分析经手术病理证实的5例黄色肉芽肿性胆囊炎的CT和MRI影像表现。结果 5例胆囊壁均增厚,胆囊壁内结节4例,5例胆囊粘膜明显强化,其中4例连续,1例中断,胆囊结石5例,其中胆囊颈结石3例,MRI邻近肝脏动脉期一过性增强3例。结论胆囊大小及胆囊壁增厚的厚度并无特异性,胆囊粘膜线光整及明显强化,胆囊壁内不明显强化结节,MRI动脉期邻近肝实质一过性强化对XGC诊断具有重要意义。此外,胆囊颈结石及胆囊腔缩小但无闭塞等对XGC的诊断可能有潜在指导意义。

Objective To explore the imaging diagnosis of Xanthogranulomatous Cholecystitis （ XGC） . Methods The mani-festations of CT and MRI of 5 patients with XGC confirmed by surgical pathology were retrospectively analyzed in this work. Re-sults Of these 5 patients with XGC, 5 presented with gallbladder wall thickening, thickened, 4 with the nodule inside the gall-bladder wall, 5 with the obvious enhancement of gallbladder mucosa, in which 4 were continuous and 1 was interruption, and 5 with gallstone, in which 3 located in the neck of gallbladder. MRI showed that 3 cases appeared the temporal enhancement at the arterial phase in adjacent liver parenchyma. Conclusion The gallbladder size and the thickness of gallbladder wall have no spe-cificity. While, the gallbladder mucosa line finishing and enhanced obviously, the unobvious nodule enhancement in gallbladder wall, and the transient arterial enhancement in MRI in adjacent liver parenchyma are of rather importance to diagnosis of XGC. In addition, the gallbladder stones and the narrow but no occlusion of gallbladder cavity, and so on may have potential implications for XGC diagnosis.