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回顾性分析4例CT误诊的胆管癌,均经手术病理证实,分析其误诊原因,报告如下.例1,腹痛、黄染1月,肝功能AST、AKP均增高,GPT200U;B超:肝内胆管扩张,胆总管无扩张;CT:肝内胆管扩张,肝总管可见等密度影.诊断胆总管高位梗阻,结石可能性大.术中见肝总管被肿块占据,质脆易出血.病理报告:胆管腺癌.例2,乏力、尿黄1周,肝功能AST、AKP均增高,GPT219 U,血清胆总红素68.5μmol/L;B超:肝内胆管扩张,胆总管扩张;CT;肝内外胆管扩张,胰头增大,诊断胆总管低位梗阻,考虑胰头癌.术中见弥漫性肝硬化,胆总管增粗,腔内填塞乳头状坏死物.病理报告:胆总管腺癌.
Retrospective analysis of 4 cases of misdiagnosis of cholangiocarcinoma by CT, were confirmed by pathology, analysis of the misdiagnosis reasons, the report is as follows. Case 1, abdominal pain, yellow dye in January, liver function, AST, AKP were increased, GPT200U; B ultrasound: intrahepatic Bile duct expansion, no expansion of the common bile duct; CT: intrahepatic bile duct dilatation, visible isodensity of the hepatic duct. Diagnosis of high common bile duct obstruction, the possibility of large stones. Liver see the liver was occupied by masses, brittle and easy bleeding. Pathology report: Biliary adenocarcinoma. Example 2, fatigue, urine 1 week, liver function, AST, AKP were increased, GPT219 U, serum bilirubin 68.5μmol / L; B-ultrasound: intrahepatic bile duct dilatation, common bile duct dilatation; CT; liver Inside and outside the bile duct expansion, pancreatic head enlargement, diagnosis of low common bile duct obstruction, consider pancreatic cancer. Intraoperative see diffuse cirrhosis, common bile duct thickening, cavity filled with papillary necrosis. Pathology report: common bile duct adenocarcinoma.