周围型肝内胆管细胞癌的CT与病理对照研究

Peripheral Type of Cholangiocarcionoma: CT and Pathologic Correlation

目的：研究周围型肝内胆管细胞癌ＣＴ表现的病理基础。探讨与其它肝内肿瘤的鉴别点。材料和方法：对照分析２２例肝内胆管细胞癌（低分化腺癌１８例、中分化腺癌２例、乳头状粘液腺癌２例）手术切除标本病理所见与ＣＴ（２２例）、超声（９例）、血管造影（２例）表现。结果：ＣＴ上瘤块呈均匀低密度（９０％）──反映肝内胆管细胞癌瘤体很少出现出血、坏死、囊变的均质特征；瘤块边界不清（１００％）与肿瘤的浸润性生长方式和缺少纤维包膜有关；增强后仅有轻度强化提示肿瘤的少血管特性；所有病例都无肝硬化的ＣＴ表现。结论：周围型肝内胆管细胞癌有着和其他肝肿瘤（特别是肝细胞癌）不同的病理特征，ＣＴ检查对此可作出较正确判断。

Purpose: A study of the peripheral type of intrahepatic cholangiocarcinoma was undertaken to evaluate the differential diagnostic criteria with other intrahepatic tumors. Materials and Methods: A comparative study of surgical pathologic proved 22 cases of intrahepatic cholangiocarcinoma (low differentiated adenocarcinoma 18, intermediate differentiated adenocarcinoma 2, papillary mucoid adenocarcinoma 2) correlated with images taken by CT(22 cases),ultrasound (9 cases), angiography (2 cases) was undertaken. Results: CT scans showed the homogeneous densities (90%) representing the specific homogeneity due to rarely occurance of hemorrhage, necrosis and cystic change in the intrahepatic cholangiocarcinoma. The blurring of tumor borders (100%) and the infiltrating type of growth were often caused by the lack of fibrous capsules. The hypovascular nature of the tumors gave a slight density increase after intravenous enhancement. CT scans revealed no hepatic cirrhoses in all cases. Conclusion: The peripheral type of intrahepatic cholangiocarcinoma possessed the specific pathologic characteristics quite different from other hepatic tumors (especially the hepatic cell carcinoma). CT scan could contribute rather accurate diognosis.