黄色肉芽肿性胆囊炎的特征性影像表现及文献复习

The characteristic imaging findings of xanthogranulomatous cholecystitis and literature review

目的探讨黄色肉芽肿性胆囊炎(XGC)的特征性影像表现及诊断要点。方法分析1例XGC病人的增强CT表现及临床病理特征,并复习相关文献。结果 CT平扫及增强检查示胆囊轮廓毛糙,胆囊壁弥漫性增厚,腔内可见环形高密度影,与周围肝实质分界欠清,增强后胆囊壁呈明显分层样强化,邻近肝实质于动脉期呈一过性强化。病理诊断为黄色肉芽肿性胆囊炎。结论黄色肉芽肿性胆囊炎表现具有一定特征,包括胆囊壁增厚,胆囊壁呈"三明治"样或"夹心饼干"样强化、黏膜线多连续、胆囊壁内结节、胆囊或胆管结石等,有助于本病的诊断及鉴别诊断。

Objective To explore the characteristic imaging features and diagnostic key points of xanthogranulomatous cholecystitis（XGC）. Method To analyze the findings on enhanced CT images and clinicopathological features of a XGC patient. Result The plain and enhanced CT showed that the gallbladder contour was coarse with diffuse thickening of the gallbladder wall, and ring-like hyperdense inside the cavity,having no clear boundary with the surrounding liver parenchyma.The gallbladder wall showed an obvious layer-like enhancement, with a transient enhancement of near liver parenchyma in the arterial phase. The pathological diagnosis was XGC. Conclusion The XGC has some characteristics including the thickened wall with ‘sandwish-like＇ enhancement. The complete mucous line, intramural nodule and gallbladder or bile duct stone are useful for the diagnosis and differential diagnosis of the disease.