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目的探讨16排螺旋CT在周围型胆管细胞癌的诊断价值。方法回顾性分析2009年1月-2012年1月手术及病理证实的21例周围型胆管细胞癌的CT影像表现。结果 17例为单发病灶,4例为多发病灶,平扫多表现为低密度影,平均CT值37.0HU,增强扫描动脉期均有强化,强化区平均CT值52.9HU,静脉期进一步强化,强化区平均CT值75.8HU;81%可见病灶肝叶萎缩或局部肝包膜内陷,71.4%可见肝内胆管扩张,33.3%可见胆囊炎或胆囊结石。结论肝动脉期轻度强化及门脉期进一步强化是肝内胆管细胞癌的CT表现特征。肝内胆管扩张及病灶肝叶萎缩和(或)局部肝包膜内陷回缩而形成“边缘凹陷”征是肝内胆管细胞癌极其重要的间接征象。
Objective To investigate the diagnostic value of 16-slice spiral CT in peripheral cholangiocarcinoma. Methods The CT findings of 21 cases of peripheral cholangiocarcinoma confirmed by surgery and pathology from January 2009 to January 2012 were analyzed retrospectively. Results Seventeen cases were single lesions and four cases were multiple lesions. The results of plain scan showed low density, the average CT value was 37.0HU, the enhanced arterial phase was enhanced, the average CT value was 52.9HU in the enhanced area, and the venous phase was further strengthened. Intensive area average CT value of 75.8HU; 81% visible lesions of hepatic lobules or local hepatic capsule retraction, intrahepatic bile duct dilatation can be seen in 71.4%, cholecystitis or cholecystolithiasis 33.3%. Conclusions Hepatic arterial phase mild enhancement and portal phase further enhancement are the features of CT manifestations of intrahepatic cholangiocarcinoma. Intrahepatic bile duct dilatation and lesion of liver atrophy and (or) the local hepatic capsule retraction retraction and the formation of “marginal depression” sign is an important indirect intrahepatic cholangiocarcinoma.