壁厚型胆囊癌与慢性胆囊炎CT表现的研究

The CT manifestation comparison of thick-wall gallbladder carcinoma with chronic cholecystitis

目的 探讨壁厚型胆囊癌与慢性胆囊炎的鉴别诊断。方法 收集经手术和病理证实的14例壁厚型胆囊癌与14例慢性胆囊炎 ,分成良、恶两组 ,对它们的CT表现进行对比分析。结果 两组间的CT征象有许多不同。14例壁厚型胆囊癌胆囊壁均不规则增厚 ,壁僵硬9例 (64.2 % ) ,胆囊腔变小和形态失常8例 (57.1 % ) ,胆囊边界不清10例 (71.4 % ) ,9例 (64.2 % )见有不同程度的胆管扩张 ;而14例慢性胆囊炎中2例 (14.3% )壁厚薄不均 ,2例 (14.3 % )壁显僵硬 ,2例 (14.3 % )胆囊挛缩变小 ,胆囊边界不请2例 (14.3 % )。恶性组增强后见胆囊壁连续性中断5例 (37.5 % ) ,7例 (50.0% )见淋巴结肿大 ;而良性组均未见两征象。结论 螺旋CT在胆囊癌与慢性胆囊炎的鉴别诊断中有重要价值 ,上述征象出现率高的病例有助于胆囊癌的诊断。

Objective To explore the differential diagnosis between thick-wall gallbladder carcinoma and chronic cholecystitis. Methods 14cases thick-wall gallbladder carcinoma(TWGC)and14cases chronic cholecystitis(CC)proved by operation and pathology were classified into two groups,their finding of spiral CTwere analysed. Results There were many difference between thick-wall gallbladder carcinoma and chronic cholecystitis in CT imaging diagnosis.The wall thickened irregularly was observed in all TWGC group,other than2cases(14.3%)in CC group.The wall were stiff in9cases(64.2%)in TWGC group,but only2cases(14.3%)in CC group.The continuity of gallbladder wall was interrupted in5cases(35.7%)after enˉhancement in TWGC group,however the sign was not observed in CC group.The cavity of gallbladder appeared small or shape changing in8cases(57.1%)of TWGC group,but only2cases(14.3%)in CC group.The margin of gallbladder in10cases(71.4%)of TWGC group was not clear,only2cases(14.3%)in CC group.Lymph node presented large in7cases(50.0%)of TWGC group,which is not observed in CC group. Conclusion Spiral CThas important value in differential diagnosis between thick-wall gallbladder carcinoma and chronic cholecystitis.The signs mentioned above were is help for the diagnosis of gallbladder carcinoma.