肝内胆管癌的螺旋CT平扫表现分析

【摘要】  目的：探讨螺旋CT平扫诊断肝内胆管癌的临床价值及意义，以便于术前的早期诊断及治疗。方法：对我院2003年1月～2009年6月收治的经手术病理证实的23例肝内胆管细胞癌的CT资料进行回顾性分析。结果：肝内胆管细胞癌的螺旋CT平扫表现为不规则低密度肿块10例，无假包膜13例，病灶无明显占位效应4例。病灶所在肝叶萎缩8例，肿瘤周围胆管扩张12例，动态增强后特征性的渐进性、向心性强化，病灶内部呈片状、网格状或线状强化。结论：螺旋CT平扫对肝内胆管癌的早期诊断及手术定位重要的临床意义，是临床医生采用较多的辅助检查手段之一。

【关键词】  螺旋CT 肝内胆管细胞癌 临床价值

Abstract Objective:To evaluate spiral CT scan diagnosis of intrahepatic cholangiocarcinoma of the clinical value and significance in order to facilitate early diagnosis and preoperative treatment.Methods:From January 2003-2009 year in June were treated by surgery and pathology confirmed 23 cases of intrahepatic cholangiocarcinoma of the CT data were analyzed retrospectively.Result:The intrahepatic bile duct cell carcinoma of the spiral CT scan showed an irregular low-density mass in 10 cases,no false capsule in 13 cases,no significant mass effect lesions in 4 cases.Where the eight cases of hepatic lobe atrophy lesions,12 cases of biliary dilatation around the tumor,the dynamic nature of the enhanced features of the progressive nature of concentric enhancement Internal lesions was flaky,grid-like or linear strengthening.Conclusion:spiral CT scan for early diagnosis of intrahepatic cholangiocarcinoma and surgical positioning important clinical significance,is a clinician with more auxiliary examination one of the means.

　　Key words  spiral CT;intrahepatic bile duct cell carcinoma;clinical value

    资料与方法

    2003年1月～2009年6月收治的经手术病理证实的肝内胆管癌患者23例，其中男15例，女8例，男:女为1.9:1；年龄36～74岁，平均60.8岁。患者表现为上腹部不适、伴消瘦、腹部包块、黄疸，晚期有门脉高压症的表现，如畏寒，发热。所有病例经AFP检查均为阴性，CEA检查阳性4例，HbsAg检查阳性3例。
   
　　检查方法：仪器：所用CT机为东软CT-2800A ，扫描参数：120KV，175mAs，层厚10mm，层距10mm。方法：检查前服500ml水充盈胃肠道。增强扫描采用高压注射器，经肘前静脉团注优维显造影剂100ml，速率为3ml/秒。行CT动态扫描：动脉期(注射造影剂后25秒开始扫描)、静脉期(注射造影剂后60秒开始扫描)、延迟期(注射造影剂3～10分钟后扫描)。

    结  果

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