肝内胆管细胞癌CT表现

目的：通过对肝内胆管细胞癌的ＣＴ表现与手术病理对照分析以提高ＣＴ对其的诊断水平。材料和方法：１８例肝内胆管细胞癌，１例为乳头状粘液腺癌，１７例为中或低分化腺癌。所有病例术前均经Ｅｒｉｃｓｓｏｎ２４００ＣＴ机，层厚１ｃｍ及层距１ｃｍ作平扫及团注增强扫描。结果：１８例中７例为中央型，１１例为周围型。所有病例ＣＴ平扫见肿瘤边缘均不甚清晰，其中１７例肿瘤组织呈不均匀低密度，１例有点片状高密度影混杂为乳头状胆管细胞粘液腺癌的特征表现。肝内胆管细胞癌为中央型者，两侧胆管均扩大，增强后，由于肿瘤边缘的显示，肿瘤大小遂似有缩小，而最具有特征性的表现是肿瘤内可见线状征，本组病例均有此种表现。周围型均有局部肝包膜回缩表现。结论：肝内胆管细胞癌的ＣＴ表现对正确诊断有一定价值，特别是增强后肿瘤内出现的特殊线状征更具有病理影像诊断的意义。

The CT Manifestations of IntrahepaticCholangiocellular Carcinoma

urpose:Searching for the special valuable diagnostic CT manifestations of intrahepatic cholangiocellular carcinoma through the correlative study of surgical pathology.Materials and Methods:Altogether 18 cases of intrahepatic cholangiocellular carcinoma confirmed pathologically belonged to intermediate and low differentiated adenocarcinomas except 1 catalogued as papillary mucous adenocarcinoma.All cases were examined by Ericsson 2400 CT Scanner with 1cm,either as thickness or interval including plain and bolus enhancement scans.Results:Among the 18 cases,7 were catalogued to central type and the other 11 as peripheral type.On the plain CT scans,the margins of all tumors appeared unclear with heterogenous densities of the tumor tissue in 17 cases, the other 1 showed stippled punctate mixed high densities characterizing for papillary cholangiocellular mucinous adenocarcinoma.All of the central type showed both left and right intrahepatic biliary tracts'dilatation.After enhancement,a relative number of the tumors seemed to be a little smaller due to the presence of opacified periphery. The significant"Straight line" sign appearing in all cases and the "Capsular retraction" sign existed in all of the peripheral type are considered as the most characteristic manifestations. Conclusion:The specific CT manifestations provide accurate diagnostic value for intrahepatic cholangiocellular carcimoma especially the characteristic"Straight line" sign after enhancement possessing the pathogmonic significance.