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目的分析胆囊腺肌病的影像表现,提高诊断正确性。方法回顾性分析经手术病理证实的16例胆囊腺肌病患者的临床及影像资料,12例行64排螺旋CT平扫及多期动态增强扫描,7例(3例为CT检查后)MRI平扫及动态增强扫描。结果 16例胆囊腺肌病中,CT及MRI平扫表现为胆囊底部壁不均匀或结节状增厚9例,胆囊壁弥漫性增厚4例,胆囊颈及颈体交界处壁节段性增厚3例;出现典型Rokitansky-Aschoff窦(R-A窦)8例;合并结石3例。CT及MRI增强表现为动脉期黏膜强化,门静脉期强化范围进展,延迟期持续强化,R-A窦腔内无强化。结论CT、MRI平扫及增强扫描对胆囊腺肌病的诊断及鉴别诊断有重要价值;MRI显示R-A窦腔更好且具有确诊意义。
Objective To analyze the imaging manifestations of cholecystacteriosis and improve the diagnostic accuracy. Methods The clinical data and imaging data of 16 cases of cholecystacal adenomyosis confirmed by surgery and pathology were retrospectively analyzed. Twelve patients underwent 64-slice spiral CT scan and multi-phase dynamic contrast-enhanced scan, and 7 patients (3 after CT scan) Sweep and dynamic enhanced scan. Results In 16 cases of cholecystacteriosis, CT and MRI showed 9 cases with uneven or nodular thickening at the bottom of gallbladder, 4 cases with diffuse thickening of gallbladder wall and thicker wall at the junction of gallbladder neck and neck 3 cases; typical Rokitansky-Aschoff sinus (RA sinus) in 8 cases; 3 cases of stones. CT and MRI enhanced manifestations of mucosal enhancement during arterial phase, portal vein enhanced the scope of progress, continued to strengthen the delay, R-A sinus cavity without strengthening. Conclusion CT, MRI plain scan and enhanced scan of the diagnosis and differential diagnosis of gallbladder adenomyosis has important value; MRI shows that the R-A sinus cavity better and has diagnostic significance.