摘要
目的研究不伴有周围胆管扩张肝内胆管细胞癌(ICC)的计算机断层扫描(CT)表现,以提高对此类疾病的认识。方法回顾性分析14例不伴有周围胆管扩张ICC的CT表现及临床资料。结果单发病灶12例,多发病灶2例。肿块均位于肝包膜下,表现为肝内不均匀低密度灶,均未见明显钙化或结石影,边界清晰者2例,12例边界不清;发现肝包膜凹陷征6例,肝叶萎缩2例。腹腔及腹膜后淋巴结肿大者8例,门静脉内癌栓2例,肝静脉癌栓1例。动脉期边缘环形强化者及至延迟期呈填充强化8例;动脉期环形强化,门静脉、延迟期呈中间小斑片状强化3例;3例呈岛状强化型或不均匀强化型,伴有轻度延迟强化。8例进行病理分级,其中中分化腺癌3例,中低分化腺癌3例,低分化腺癌2例。结论不伴有周围胆管扩张ICC的CT表现具有一定特征性,熟练掌握其影像学特点,有助于提高对此类疾病的诊断水平。
ObjectiveTo investigate the CT features of intrahepatic cholangiocarcinoma（ICC）without peripheral bile duct dilation in order to improve the understanding on this disease.MethodsThe CT manifestations and clinical data in 14 cases of ICC without peripheral bile duct dilation were retrospectively analyzed.ResultsSingle lesion was in 12 cases and multiple lesions in 2 cases.The tumor masses were all located under the liver capsule,and manifested by uneven low density focus in liver.There was no obvious calcification or stone shadow.There were 2 cases with clear boundary,12 cases with unclear boundary,6 cases with hepatic capsule depression and 2 cases with hepatic lobe atrophy.Abdominal and retroperitoneal lymph node enlargement was in 8 cases,portal vein tumor thrombus was in 2 cases and hepatic vein tumor thrombus was in 1 case.The edge ring enhancement in arterial phase and the filled enhancement until delayed phase were in 8 cases;ring enhancement in arterial phase and middle small patchy enhancement in portal venous and delayed phase were in 3 cases;3 cases showed island enhancement or inhomogeneous enhancement complicating slight delayed enhancement.The pathological grading was carried out in 8 cases,including 3 cases of moderately differentiated adenocarcinoma,3 cases of moderately and poorly differentiated adenocarcinoma and 2 cases of poorly differentiated adenocarcinoma.ConclusionThe CT features of ICC without peripheral bile duct dilation have a certain characteristics,proficiently mastering its imaging features is helpful to improve the diagnostic level of this disease.
出处
《检验医学与临床》
CAS
2017年第22期3359-3360,3362,共3页
Laboratory Medicine and Clinic
