摘要
目的 :探讨肝门区胆管癌的螺旋CT增强扫描表现与病理学的关系以及螺旋CT对本病的诊断价值。方法 :回顾性分析 3 3例经手术及病理证实的肝门区胆管癌的螺旋CT平扫及多期增强扫描资料 ,将本病分为结节型和浸润型进行观察 ,重点观察肿块相对于肝脏的密度变化。结果 :结节型 2 8例 ( 84.8% ) ,浸润型5例 ( 15 .2 % )。 75 % ( 2 1/2 8)的结节型病变于门脉期 ( 10例 )和延迟期 ( 11例 )显示最清楚 ,19例有延迟强化 ,延迟强化率为 67.9% ( 19/2 8) ;80 % ( 4例 )的浸润型病变于动脉期显示最清楚 ,仅有 1例有延迟强化表现。此外螺旋CT还清楚地显示了胆管扩张 ,肝叶萎缩 ,病变周围的异常强化区等间接征象。结论 :不同病理类型的胆管癌其CT表现不同 ,螺旋CT多期增强扫描是诊断和鉴别诊断肝门区胆管癌的理想的检查手段。
Objective: To evaluate diagnostic value of contrast-enhanced helical CT in hilar cholangiocarcinoma by correlating the CT appearances with pathologic basis.Methods: 33 patients with pathologically proven hilar cholangiocarcinoma were performed unenhanced,muti-phase dynamic contrast enhanced CT scanning . Hilar cholangiocarcinoma was divided into two types:infiltrating type and nodular type,then,attenuation of tumor relative to the liver was mainly observed.Results: 28 of 33(84.4%) patients were nodular type,5 (15.2%) were infiltrating type. 75% (21/28) nodular type can be manifested distinctly in portal venous phase(VP)(n 10 ) and delayed phase(DP)(n 11),19 patients had delayed contrast enhancement features,the rate of contrast enhancement was 67.9%(19/28);80%(4/5).Infiltrating type lesions(4 patients) can be exhibited clearly in arterial phase(AP,only one patient had delayed contrast enhancement .Moreover, ancillary findings of the intrahepatic biliary ducts,hepatic lobar atrophy,the abnomal enhancement areas peripheral to the tumor were also seen in helical CT ,when present may suggest hilar cholangiocarcinoma.Conclusion: Different types of hilar cholangiocarcinoma have different CT appearances.Muti-phase contrast enhanced helical CT scan is a ideal method of diagnosis and differential diagnosis of hilar cholangiocarcinoma.
出处
《河南医学研究》
CAS
2003年第4期300-303,共4页
Henan Medical Research
基金
河南省医学科技创新人才工程项目 ( 2 0 0 0 2 0 8)