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目的探讨肝内周围型胆管细胞癌的螺旋CT诊断及鉴别诊断。方法回顾中山火炬开发区医院2007年1月-2011年12月确诊的42例肝内周围型胆管细胞癌的螺旋CT影像表现。结果病灶位于肝右叶25例,占59.52%;表现为囊性或多囊性29例,占69.6%;边缘分叶征30例,占71.43%;病灶周围胆管扩张28例,占66.6%;病灶延迟强化35例,占83.33%;肝门区、腹腔淋巴结转移27例,占64.29%。结论①肝内周围型胆管细胞癌的临床表现缺乏特征性,但是,华支睾吸虫肝病感染者中肝内周围型胆管细胞癌的发生率较高。②肝内周围型胆管细胞癌的螺旋CT表现具有一定的特征性,掌握这些特征,影像诊断不难。③肝内周围型胆管细胞癌的螺旋CT检查应常规进行增强并延时扫描。
Objective To investigate the diagnosis and differential diagnosis of intrahepatic peripheral cholangiocarcinoma by spiral CT. Methods The CT findings of 42 cases of intrahepatic peripheral cholangiocarcinoma confirmed by Zhongshan Torch Development Hospital from January 2007 to December 2011 were retrospectively reviewed. Results The lesions were located in the right lobe of the liver in 25 cases (59.52%), cystic or polycystic (29 cases, 69.6%), marginal lobulation (30 cases), accounting for 71.43%. The lesions around the bile ducts were expanded in 28 cases (66.6%). Delayed enhancement of lesions in 35 cases, accounting for 83.33%; hilar region, abdominal lymph node metastasis in 27 cases, accounting for 64.29%. Conclusions ① The clinical manifestations of intrahepatic peripheral cholangiocarcinoma are characteristic. However, the incidence of intrahepatic cholangiocarcinoma in Clonorchis sinensis is high. ② spiral CT of intrahepatic peripheral cholangiocarcinoma has certain characteristics, to master these features, imaging diagnosis is not difficult. ③ intrahepatic peripheral cholangiocarcinoma spiral CT examination should be routinely enhanced and delayed scan.