摘要
目的:对比研究肝内周围型胆管细胞癌的临床病理与CT及MRI表现。方法:回顾性分析经病理学证实的周围型胆管细胞癌39例,32例行CT平扫和动态增强扫描,11例行MRI扫描,其中4例同时做过CT和MRI检查。结果:肿瘤在CT、MRI上表现为类圆形软组织肿块(肿块型)、不规则形片状异常密度(信号)影(浸润生长型)和扩张胆管腔内结节样(或菜花样)软组织肿块,动态增强扫描早期呈轻度强化,以边缘为主,延迟后扫描病灶可无明显强化,或内部呈现片状、分隔状甚至均匀性强化。病理学上见肿瘤细胞呈高柱状、立方形或扁平形排列成腺管状,中间含有增生的纤维结缔组织,在不同类型肿瘤中两者含量和分布特点不同构成不同影像表现的病理学基础。结论:周围型胆管细胞癌的临床表现缺乏特异性,动态增强扫描是CT、MRI诊断和鉴别诊断要点,排列成腺管状的瘤细胞造成肿瘤早期强化,而增生的纤维结缔组织是形成肿瘤延迟强化的病理基础。
Objective:To study the clinical characteristics,histopathologic findings and imaging features on the CT and MRI of intrahepatic peripheral cholangiocarcinoma (IHPCC).Methods:Thirty-nine patients (male 25 cases and female 14 cases) with pathologically proven IHPCC were reviewed retrospectively.Thirty-two patients were performed CT non-enhanced scanning and dynamic enhancement. MR imaging were obtained in eleven patients,both CT and MRI were performed in 4 cases.Results:On the CT and MRI,the lesions of IHPCC showed round,mass (mass-type 19 cases),irregular shape and patchy abnormal density (signal) with intrahepatic bile duct dilation (infiltrative type 8 cases),or node-like soft tissue mass in the dilatant biliary duct (intracavitary type 7 cases),that displayed low density on the non-enhancemened CT scan,and homogeneous hypointensity on T_1-weighted imaging,heterogeneous hyperintensity on T_2-weighted imaging.No contrast or rimelike contrast enhancement was observed in early phase and patchy,seperated or homogeneous enhancemen in the central regions in the delayed phase of dynamic enhancement.The tumors were consisted of tumor cells that arranged like glandular duct with fibrous connective tissue at the histopathologic analysis.The content of these portions were different in different positions and different types of tumor,it was the pathological base of different imaging futures of HPCC.Conclusion:The clinical characteristic of HPCC patients was lack of specificity.Dynamic contrast enhancement scan was important techniques for the correct diagnosis of IHPCC.Typical feature of IHPCC is peripheral enhancement at the early stage and delayed contrast enhancement at the tumor center on the dynamic contrast enhancement scan.At the edge of tumor,the main components were living tumor cell that contribute to the early contrast enhancement.The delay contrast enhancement was due to fibrosis that mainly situated in the tumor center.
出处
《放射学实践》
2005年第6期497-500,共4页
Radiologic Practice
关键词
胆总管疾病
细胞
体层摄影术
X线计算机
磁共振成像
病理学
Common bile duct diseases
Cells
Tomography,X-ray computed
Magnetic resonance imaging
(Pathology)
