不典型肝内胆管细胞癌合并脓肿的影像诊断要点

发布时间：2018-01-21 15:02

本文关键词： 肝脏胆管细胞癌肝脓肿体层摄影术 X线计算机磁共振成像　出处：《国际医学放射学杂志》2016年05期 　论文类型：期刊论文

【摘要】：目的探讨不典型肝内胆管细胞癌合并肝脓肿的影像表现特征和诊断要点。方法回顾性分析1例经手术病理证实为肝内胆管细胞癌合并肝脓肿病人的临床资料、影像表现特征并复习相关文献。结果 MDCT平扫显示巨大不规则肿物,累及肝左叶及部分右前叶,肿物呈分叶状,内部密度不均,邻近血管无受侵、肝包膜无凹陷征;增强CT检查动脉期显示肿物呈多结节融合状,病灶边缘及内部各结节呈明显环形强化,门静脉期及平衡期肿物强化仍较明显。肝脏MRI平扫肿物呈不规则形稍长T1、稍长T2信号影,于DWI序列上显示不均匀较明显高信号,增强扫描表现类似于增强CT表现,另于MRI增强扫描门静脉期及平衡期可见肿物内局部区域呈分房状表现,增强程度更明显。结论不典型肝内胆管细胞癌合并肝脓肿兼具两种病变的影像表现。正确诊断需结合临床、实验室检查、超声表现并注重影像表现的细节信息。
[Abstract]:Objective to investigate the imaging features and diagnostic features of atypical intrahepatic cholangiocarcinoma with liver abscess. Methods A case of intrahepatic cholangiocarcinoma with liver abscess proved by operation and pathology was retrospectively analyzed. Results MDCT plain scan showed huge and irregular masses involving Zuo Ye of liver and part of right anterior lobe. The masses were lobular with uneven internal density and no invasion of adjacent blood vessels. There was no indentation in hepatic capsule. Contrast-enhanced CT showed that the tumor was multi-nodular fusion in arterial phase, and the nodules in the edge and inside of the lesion were obviously circular enhancement. The enhancement of tumor in portal vein and balance phase was still obvious. MRI plain scan showed irregular shape slightly longer T _ 1 and slightly longer T _ 2 signal intensity, and showed heterogeneity and higher signal intensity on DWI sequence. Contrast-enhanced CT findings were similar to those of contrast-enhanced CT, and the local areas of tumors in portal phase and equilibrium phase of MRI enhanced scanning showed sectional-like manifestations. Conclusion atypical intrahepatic cholangiocarcinoma combined with liver abscess has two kinds of imaging manifestations. The correct diagnosis should be combined with clinical, laboratory, ultrasonic findings and pay attention to the details of the imaging findings.
【作者单位】：天津市第三中心医院天津市肝胆研究所天津市人工细胞重点实验室卫生部人工细胞工程技术研究中心天津市血液灌流企业重点实验室天津医科大学三中心临床学院;
【分类号】：R735.8;R445.2;R730.44
【正文快照】： 肝内胆管细胞癌是一种较常见的肝脏原发恶性肿瘤,属腺癌,起源于末梢胆管上皮或肝内小胆管,好发于老年人[1]。肝脓肿是肝组织局限性化脓性炎症,典型的肝脓肿在CT和MRI增强检查中较易正确诊断[2]。然而,不典型的肝脓肿在影像诊断中需与肝内胆管细胞癌鉴别。本文就1例胆管细胞

【相似文献】