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目的分析肿块型肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)的多层螺旋CT(MSCT)表现。资料与方法回顾性分析56例经病理证实的ICC患者的MSCT表现,对肝脏形态、胆道结石、胆管扩张、病灶的强化方式、门静脉形态及肝十二指肠及腹膜后淋巴结等进行分析总结。结果 56例中54例行平扫加增强扫描,其中环形强化21例(38.9%),片状强化24例(44.4%),延迟强化39例(72.2%),无明显强化1例(1.9%);门静脉变窄或闭塞37例(68.5%),门静脉癌栓15例(27.8%);周围胆管扩张35例(62.5%);子灶18例(32.1%);胆道结石21例(37.5%),ICC合并同叶肝内胆管结石17例(30.4%);肝叶萎缩20例(35.7%);包膜皱缩38例(67.9%);肝十二指肠韧带和/或腹膜后淋巴结肿大31例(55.4%);胆囊炎36例(64.3%)。ICC合并同叶肝内胆管结石的发生率与ICC不合并同叶肝内胆管结石的发生率二者间的差异具有统计学意义(χ2=9.905,P=0.002)。结论环形或片状强化、延迟强化、门静脉狭窄/闭塞、包膜皱缩是肿块型ICC的主要CT特征性表现。
Objective To analyze the multi-slice spiral CT (MSCT) manifestations of intrahepatic cholangiocarcinoma (ICC). Materials and Methods Retrospective analysis of 56 cases of pathologically confirmed ICC patients with MSCT manifestations of liver morphology, biliary calculus, bile duct dilatation, enhancement of the lesion, portal vein morphology and liver duodenum and retroperitoneal lymph nodes were analyzed and summarized. Results Of the 56 cases, 54 cases underwent scan and contrast enhanced scan, of which 21 cases (38.9%) were annular enhancement, 24 cases (44.4%) were laminar enhancement, 39 cases (72.2%) delayed enhancement, and 1 case (1.9% ); Portal vein narrowing or occlusion in 37 cases (68.5%), portal vein tumor thrombus in 15 cases (27.8%); peripheral bile duct dilatation in 35 cases (62.5%); foci in 18 cases (32.1% ), ICC with ipsilateral intrahepatic bile duct stones in 17 cases (30.4%); lobular atrophy in 20 cases (35.7%); capsule shrinkage in 38 cases (67.9%); hepatoduodenal ligament and / or retroperitoneal lymph node 31 cases (55.4%) were swollen, 36 cases (64.3%) of cholecystitis. The incidence of intrahepatic cholecystolithiasis with ICC and the incidence of intrahepatic cholecystolithiasis in ICC were statistically different (χ2 = 9.905, P = 0.002). CONCLUSIONS: Annular or platelet enhancement, delayed enhancement, portal vein stenosis / occlusion, and envelope shrinkage are the major CT features of mass-type ICC.