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与肝吸虫感染相关的肝外型胆管癌的CT评价

The CT Feature of Extrahepatic Cholangiocarcinoma (EHCC) Associated with Clonorchiasis

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【作者】 李鹏赵欣曾红辉龙健张浩杨六成黄宝裕莫顶立赖维湛

【Author】 LI Peng, ZHAO Xin, ZENG Hong-hui , et al. Department of Radiology, Rongqi Hospital, Shunde, Foshan 528303,China

【机构】 广东省佛山市顺德区容奇医院放射科广东省佛山市顺德区容奇医院普外科广东省佛山市顺德区容奇医院普外科 广东佛山528303广东佛山528303广东佛山528303

【摘要】 目的研究肝吸虫感染引起的肝外型胆管癌的CT特征。方法回顾性分析19经手术和病理证实,与肝吸虫感染相关的肝外型胆管癌的CT征象,包括肿瘤在肝外胆管生长部位、生长方式、形态、强化情况,对周围器官的侵犯,淋巴转移,胆管扩张情况。结果18例CT均准确发现和定位,发生在左右肝管或肝总管14例(77.8%),发生在胆总管上中段1例(5.6%),发生在胆总管下端或壶腹部3例(16.7%)。肿瘤生长方式呈腔内型14例(77.8%),肿块型2例(11.1%),浸润型2例(11.1%)。增强扫描后肿瘤相对于肝组织呈等密度10例(55.6%),呈高密度6例(33.39%),呈低密度2例(11.1%)。肝内胆管严重、均匀型扩张14例,中央型扩张3例,轻度扩张1例。男性多见(n=15,83·3%)。结论与肝吸虫相关的肝外型胆管癌多发生在肝外胆管近端三分之一,腔内生长多见,老年男性多见,而且较非肝吸虫性肝外型胆管癌更易发现。

【Abstract】 Objective To investigate the CT imaging feature of EHCC associated with Clonorchiasis. Methods The CT image features of 18 patients with EHCC associated with Clonorchiasis proved by operation and pathology were reviewed retrospectively. Results CT depicited the level and cause of obstruction in all eigthteen patient. Most tumors( n =14,77.8%)were located in the proximal third of the extrahepatic bile duct. The gross morphologic pattern was an intraluminal soft tissue mass leision in 14 patients(77.8%), infiltrating in two patients and exophytic types in two patients. Contrast enhancement of the tumors relative to the liver parenchyma showed isoattenueation in 10 tumors(55.6%), hyperattenuation in seven tumors(38.9%) and hypoattenuation in one tumor(5.6%). Severe,uniform dilation of the intrahepatic bile duct was identified in 14 patients (77.8%) and central dilation was seen in four patients (23.2%).Male preponderance was found( n =15,83.3%). Conclusion It is concluded that the EHCC associated with Clonorchiasis is located predominantly in the proximal third of the extrahepatic bile duct and detected more readily than non Clonorchiasis-associated cholangiocacinoma.

  • 【文献出处】 中国医师杂志 ,Journal of Chinese Physician , 编辑部邮箱 ,2005年S1期
  • 【分类号】R735.8
  • 【下载频次】79
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