螺旋CT多期增强在肝内周围型胆管细胞癌诊断中的应用价值.doc

螺旋CT多期增强扫描在肝内周围型胆管细胞癌诊断中的应用价值 【摘要】 目的 研究肝内周围型胆管细胞癌（IHPCC）CT的多期增强扫描的应用价值。 方法 23例行CT平扫及多期增强扫描，对所以患者进行回顾性分析。 结果 23例中，单发21例，多发2例，位于左叶13例，右叶8例，同时累及左右叶例。网格样、斑片样强化轻度不规则斑片状增强3例全部病例未见门、腔静脉瘤栓。sumary Aim: The Study of CT multi-phase Enhancement Scanning Applied Value of IHPCC. Method: 23 cases of CT scan and CT multi-phase Enhancement Scanning, getting the retrospective analysis of patients. Result: The 23cases include 21 single cases and 2 multiple cases. Thereinto, 13 cases are on the left liver lobe, 8 cases are on the right part, and 2 cases refer to both. CT scan makes low or normal density and presents circular, quasi-circular or irregular form.4 cases present crypto mere and point calcification.13 cases merge intrahepatic bile ducts dilation, 5 of which encircle lump.4 cases are cirrhosis. 9 cases present incisura like navel beside liver. 11 cases merge calculus of bile duct , 7 cases are Portal lymph node enlargement, 12 cases are retroperitoneal lymph node enlargement. Enhancing the Scanning of the arterial phase and portal vein phase, The focus of the 23 cases are more obvious than arterial phase.Thereinto, 8 cases present edge irregular ring reinforcement. 12 cases present piece of flocculent， grid sample and patchy. 3 cases enhance mild irregular patchy. Multiple cases enhance persistently, and the minority is similar to the priority, and the minimal fall a little comparing to the priority. Portal and cava tumor embolus are not discovered in all the cases. Conclusion：IHPCC gets features in the spiral CT multi-phase Enhancement Scanning. Key Words：spiral CT、liver、cholangiocarcinoma、multi-phase Enhancement Scanning 肝内周围型胆管细胞癌（intrahepatic peripheral cholangiocarcinoma, IHPCC），是肝脏第二高发的原发性恶性肿瘤，占肝内原发恶性肿瘤的3.25~10%。随着临床治疗技术的不断提高，早期诊断IHPCC已经引起临床相关学科的重视，目前CT是诊断本病最常用的影像检查方法。本文分析IHPCC螺旋CT多期增强扫描征象，旨在提高对其诊断及鉴别诊断水平，为临床早期发现、早期治疗、提高患者术后生存率提供影像依据。 1 材料与方法 1.1 一般资料 收集2005年10月至2011年12月经手术或穿刺活检病理证实的IHPCC患者23例，其中男性14例，女性9例，年龄44~75岁，平均58.7岁。临床主要表现为右上腹胀痛不适、间歇式皮肤巩膜黄疸、贫血、乏力消瘦、畏寒发热、无痛性进行