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目的:对照分析肝内胆管囊腺瘤及囊腺癌的螺旋CT表现与病理结果,旨在提高其影像诊断水平。方法:回顾性分析8例肝内胆管囊腺瘤及囊腺癌病例的病理资料及螺旋CT表现,其中囊腺癌3例,囊腺瘤5例,所有病例均经手术病理证实。8例均行CT平扫及动脉期、门静脉、延时期三期增强扫描。结果:8例患者的病灶均呈薄壁囊性肿物,圆形、类圆形分叶状或趋于分叶状,外缘光滑7例,1例伴发感染而外缘模糊。3例囊腺癌中,囊内出血1例,囊液密度均匀2例;多房伴分隔2例;伴细小囊壁钙化1例,粗大壁结节3例。5例囊腺瘤中,多囊伴分隔4例,分隔菲薄均匀;囊液密度均匀5例;伴细小壁结节3例;增强后病灶囊壁、分隔及壁结节均呈持续强化改变。病理上,大体所见与影像学所见相似,为类圆形、边界清楚囊性病灶;镜下,囊壁内衬单层上皮,上皮下为致密纤细的梭形间质细胞增生,肿瘤间质血管较少。结论:肝内胆管囊腺瘤及囊腺癌的螺旋CT表现具有一定特征性,CT平扫和动态增强能较好地反映其病理学特点,有助于该疾病的诊断。
OBJECTIVE: To compare and analyze the spiral CT findings and pathological findings of intrahepatic cholangiocarcinoma and cystadenocarcinoma in order to improve its diagnostic value. Methods: Eight cases of intrahepatic cholangiocarcinoma and cystadenocarcinoma were retrospectively analyzed. Pathological data and spiral CT findings were retrospectively analyzed, including 3 cases of cystadenocarcinoma and 5 cases of cystadenocarcinoma. All cases were confirmed by surgery and pathology. Eight patients underwent CT scan and arterial phase, portal vein, delayed phase three enhanced scan. Results: The lesions of all 8 patients showed thin cystic masses, round, round lobular or lobular lobes with smooth outer rim in 7 cases and 1 case with peripheral infection. 3 cases of cystadenocarcinoma, 1 case of intracapsular hemorrhage, cyst fluid density in 2 cases; room with 2 cases of separation; with small wall calcification in 1 case, 3 cases of coarse wall nodules. 5 cases of cystadenoma, multiple cysts with separation of 4 cases, separated meager uniform; cyst fluid density in 5 cases; with small wall nodules in 3 cases; enhanced lesion wall, separation and wall nodules were continuously enhanced changes. Pathologically, the general findings and imaging findings similar to the round, clear cystic lesions border; microscopic, wall lined with monolayer epithelial, subcutaneous epithelial dense dense spindle cells interstitial cells between the tumor Less blood vessels. Conclusion: The spiral CT findings of intrahepatic cholangiocarcinoma and cystadenocarcinoma have certain characteristics. CT scan and dynamic enhancement can well reflect the pathological features and contribute to the diagnosis of this disease.