摘要
目的 了解螺旋CT诊断小胆总管癌 (≤ 2cm)的临床价值。资料与方法 回顾性分析 1 0例经手术病理证实小胆总管癌的螺旋CT表现。螺旋CT平扫层厚和间隔为 1 0mm ,增强采用薄层动脉和门脉双期扫描。动脉期扫描采用层厚 5mm ,螺距 1 .0 ,延迟扫描时间 30s;门脉期扫描层厚和间隔均为 5mm ,延迟扫描时间 70s。对比剂总量90ml,注射流率 3ml/s。结果 1 0例小胆总管癌的肿瘤病灶均≤ 2cm ,其中病灶直径最小为 1 .0cm ,最大为 2 .0cm。所有病例均见肝内胆管扩张、胆囊增大和胆总管扩张。螺旋CT平扫 1例显示胰头平面高密度 ,其余均为等密度病灶 ;动脉和门脉期扫描胰头水平所有肿瘤均匀或不均匀的明显强化 ,同时 2例肿瘤邻近层面的胆总管壁不规则的环状强化 ,其厚度超过 2mm以上。所有胆总管至胰头平面均呈“截断”改变 ,50 %的病例可见“晕圈征”。结论 小胆总管癌的螺旋CT特征性表现
Objective To evaluate spiral CT scan in the diagnosis of small cholangiocarcinoma (≤2cm).Materials and Methods CT findings of 10 cases with pathologically proved small cholangiocarcinoma were retrospectively analyzed. For plain scanning 10mm thickness and interval were used, while for enhanced scanning 5mm thickness and 1.0 pitch with a delayed time of 30s were used in arterial phase, and 5mm thickness and 5mm interval with a delayed time of 70s were used in portal phase. A total 90ml of contrast media was used with an injection rate of 3ml/s.Results The tumor size of 10 cases varied from 1.0cm to 2.0cm. Dilated intrahepatic and common bile ducts together with enlarged gallbladder were seen in all cases. The lesion at pancreatic head level displayed hyper density in one and iso density in 9 cases on plain CT scans, and showed homogenous or inhomogenous enhancement on enhanced CT scans during arterial and portal phases. In two cases, the common bile duct wall at adjacent sections showed irregular ring like enhancement, the thickness of which was over 2mm. Abruption of common bile duct at pancreatic head level was seen in all cases, and a thin 'crescent sign' was demonstrated in half cases.Conclusion On thin slice enhanced spiral CT scans, the characteristic manifestation of small cholangiocarcinoma is the homogenous or inhomogenous enhancement of the lesion at pancreatic head level during both the arterial and portal phases.
出处
《临床放射学杂志》
CSCD
北大核心
2002年第9期704-707,共4页
Journal of Clinical Radiology
关键词
小胆总管癌
螺旋CT
诊断
胆总管
Common bile duct Cholangiocarcinoma Tomography, X ray computed
