周围型肝内胆管细胞癌的CT表现

目的：探讨周围型肝内胆管细胞癌（IHPCC）的CT表现及其诊断价值。方法：收集21例经手术病理证实IHPCC的CT表现进行回顾性分析。结果：21例平扫表现为低密度病灶,多数边界不清,伴病灶周边胆管扩张15例,肝内胆管结石9例,胆总管结石2例;伴肝叶萎缩13例,病灶局部肝轮廓凹陷10例;增强扫描动脉期病灶周边环形、结节状强化19例,内部呈斑片状强化7例,线样强化5例、网格状强化4例,静脉期及延迟10~15min后扫描病灶有进一步强化、充填,呈现渐进性强化的特点。发现肝门周围和后腹膜区淋巴结肿大8例,无弥漫性肝硬化表现及门静脉癌栓形成征象。结论：IHPCC与其它肝肿瘤及非肿瘤性病变有着不同的病理和CT表现特征,螺旋CT动态多期增强扫描对IHPCC的诊断具有重要的临床应用价值。

CT findings of intrahepatic peripheral cholangiocarcinoma

Objective：To analyse the CT features of intrahepatic peripheral cholangiocarcinoma（IHPCC） and to evaluate its value in the diagnosis of IHPCC.Methods：The CT features of 21 cases of surgically and pathologically confirmed IHPCC were retrospectively reviewed and analysed.Results：On the plain CT scans, 21 cases were of low density with ill defined border.Among 21 cases,there was a dilation of intrahepatic biliary ducts in 15 cases,a hepatolithiasis in 9 cases and common duct stones in 2 cases.Atrophy of hepatic lobe was found in 13 cases,and local retraction of the liver capsule adjacent to the tumor was displayed in 10 cases.On contrast-enhanced CT,a peripheral ring and nodular enhancement was found in 19 cases,and some patchy enhancement in 7 cases,linear enhancement in 5 cases and network enhancement in 4 cases on arterial phase in internal region.There was a further enhancement in the lesions on venous phase and 10～15 mins delayed phase.8 cases showed lymph node enlargment in hilar of liver and retroperitoneal space.No diffuse hepatic cirrhosis and portal vein tumor thrombi were found.Conclusion：There are some CT and pathological characteristics of IHPCC,which are useful for differentiating IHPCC from other space occupying lesions in the liver.CT dynamic scanning has an important value in the diagnosis of IHPCC.