胆囊腺瘤及其局部癌变的MRI诊断

发布时间：2018-02-07 13:53

本文关键词： 胆囊腺瘤癌变磁共振成像　出处：《临床放射学杂志》2016年01期 　论文类型：期刊论文

【摘要】：目的探讨胆囊腺瘤(AG)及其局部癌变的MRI特征,以提高对该类疾病的诊断水平。方法回顾性分析经手术病理证实的18例AG患者的MRI资料,其中5例局部癌变。由2名高级职称影像诊断医师分别独立进行图像分析,观察肿瘤的部位、数量、大小、形态、信号、强化程度、肿瘤与胆囊壁的关系及伴随情况。结果 18例中位于胆囊体部10例,底部7例,颈部1例;单发病灶15例,多发3例。13例AG中,最大径0.5 cm 2例,均呈乳头状,表面光整,动脉期呈轻度均匀强化。0.5~1 cm 4例,乳头状和椭圆形各2例;表面光整1例,表面不光整并桑葚征3例;动脉期轻度均匀强化1例,中度均匀强化3例。1 cm 7例,乳头状1例,椭圆形和菜花状各3例;表面均不光整,并可见桑葚征;增强扫描动脉期中度均匀强化6例,明显强化1例。所有病灶均为窄基底,在T1WI和T2WI上为均匀等信号。5例AG局部癌变病灶(大小?),椭圆形1例,菜花状4例;边界光整1例,表面不光整并桑葚征4例;窄基底2例,宽基底3例。在T1WI和T2WI上均为均匀等信号;增强扫描动脉期明显均匀强化2例,明显不均匀强化3例。附着处胆囊壁局限性增厚3例,侵犯肝脏1例。结论胆囊内窄基底肿块伴桑葚征,应考虑AG的诊断;若病灶局部基底增宽、桑葚征减少、明显不均匀强化、附着处胆囊壁局限性增厚或周围组织侵犯,需考虑AG癌变的可能。
[Abstract]:Objective to investigate the MRI features of adenoma of gallbladder (AGG) and its local carcinogenesis in order to improve the diagnostic level. Methods the MRI data of 18 patients with AG proved by operation and pathology were analyzed retrospectively. Among them, 5 cases of local carcinogenesis were analyzed independently by two senior image diagnostics doctors, and the location, quantity, size, shape, signal, enhancement degree of the tumor were observed. Results among 18 cases, 10 cases were located in the body of the gallbladder, 7 cases in the bottom, 1 case in the neck, 15 cases had single focus, 3 cases had multiple AG, 2 cases had the largest diameter 0.5 cm, all of them were papillary and smooth. Mild homogeneous enhancement was observed in 4 cases, papillary and elliptic in 2 cases, smooth surface in 1 case, and mulberry sign in 3 cases, mild homogeneous enhancement in 1 case, moderate homogeneous enhancement in 3 cases, papillary homogeneous enhancement in 7 cases, papillary pattern in 1 case, mild homogeneous enhancement in 1 case, moderate homogeneous enhancement in 3 cases, papillary pattern in 1 case. Oval and cauliflower shape in 3 cases, the surface was not only complete, but mulberry sign could be seen. In 6 cases of moderate homogeneous enhancement of arterial phase, 1 case was obviously enhanced. All lesions were narrow basal. Homogeneous signal intensity on T1WI and T2WI was found in 5 cases of AG local cancerous lesions (size? In 1 case, ellipse, 4 cases of cauliflower, 1 case of boundary light, 4 cases of mulberry sign, 2 cases of narrow base and 3 cases of wide base. The signal intensity was homogenous on T1WI and T2WI. There were 3 cases of obvious uneven enhancement, 3 cases of localized thickening of the gallbladder wall and 1 case of hepatic invasion. Conclusion the diagnosis of AG should be considered if the local basement of the lesion is enlarged, and the mulberry sign is decreased, conclusion there is a narrow basal mass in the gallbladder with mulberry sign. The possibility of AG carcinogenesis should be considered because of obvious uneven enhancement, localized thickening of gallbladder wall or invasion of surrounding tissues.
【作者单位】：浙江大学医学院附属第二医院放射科;浙江省新昌县中医院放射科;
【分类号】：R735.8;R445.2

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