CT动态增强扫描对周围型肝内胆管细胞癌的诊断价值

目的探讨螺旋CT动态增强扫描对肝内胆管细胞癌的应用价值及表现特点。方法回顾性分析经手术病理证实或/和穿刺活检的肝内胆管细胞癌28例,所有病例均行CT平扫和动态增强扫描,所有病例均做甲胎蛋白(AFP)检查。结果 15例动脉期病灶边缘呈花环样或不规则状强化,门脉期、静脉期及延时期逐渐向病灶中心强化,病灶周边随时间推移逐渐降低;12例动脉期边缘轻度强化,门脉期、静脉期及延时期向心性强化;2例表现为轻度不均匀强化,随时间延长病灶中央呈网格状强化;5例合并肝内胆管轻度扩张;6例合并胆管结石或小斑片状钙化灶;23例AFP检查为阴性,5例AFP检查为阳性。结论肝内胆管细胞癌的多层螺旋CT动态增强扫描影像表现具有一定特性,对肝内胆管细胞癌确诊有一定帮助。

The Diagnostic Value of Contrast Enhanced CT Scan in the Diagnosis of Intrahepatic Cholangiocarcinoma

Objective Investigate the dynamic enhanced spiral CT scan on intrahepatic cholangiocarcinoma application value and characteristics.Methods A retrospective analysis was proved by operation and pathology or / and biopsy of the intrahepatic bile duct carcinoma in 28 cases,all cases underwent CT plain and dynamic enhanced scan,all cases were examined with alpha-fetoprotein(AFP) examination.Results 15 cases of arterial lesions in edge was rosettelike or irregular enhancement,portal venous phase delay period,and gradually to the center of the lesion enhancement,lesions of the peripheral with time gradually decreased;in 12 cases of arterial phase edge enhancement,portal venous phase and delay period,centripetal and strong;in 2 cases mild uneven enhancement,with extended time lesions of the central cancellate reinforcing;in 5 cases with intrahepatic bile duct mild dilatation;in 6 patients with calculus of bile duct;in 23 cases of AFP examination is negative,5 patients tested positive for the AFP.Conclusion Intrahepatic cholangiocarcinoma dynamic enhanced multi-slice spiral CT scan imaging has certain characteristics,diagnosis of intrahepatic bile duct carcinoma have some help.