【摘要】 目的研究肝内周围型胆管细胞癌(IHPCC)的CT动态增强扫描影像学特征与其病理基础。方法回顾性分析经病理证实的IHPCC病例25例,所有25例病例均行CT平扫和三期动态增强CT扫描。结果病灶位于肝左叶17例(76%),位于肝右叶8例(24%)。影像学上病灶呈肿块型15例(60%)、浸润狭窄型5例(20%)、腔内生长型3例(12%),有2例(8%)未见明确肿块。病灶多数呈类圆形或不规则分叶形。CT动态增强扫描表现为早期以边缘为主的轻度强化,延迟后扫描病灶可无明显强化,或内部出现分隔状、片状甚至均匀性强化。病理学上见肿瘤主要由肿瘤细胞、纤维组织和凝固坏死成分组成,在肿瘤外周以存活肿瘤细胞为主,形成早期边缘强化,而肿瘤中央以纤维成分为主,是产生延迟强化的病理基础。结论 CT动态增强扫描是诊断IHPCC的重要技术,早期边缘强化、延迟后内部强化是其特征性影像学表现。更多还原

【Abstract】 Objective To study the characteristics of imaging features of intrahepatic peripheral cholangiocarcinoma (IHPCC) on the dynamic contrast-enhanced CT and correlate these features with histopathologic findings.Methods 25 cases with pathologically proven IHPCC were reviewed retrospectively.All 25 cases underwent unenhanced and triphasic dynamic contrast-enhanced CT of the abdomen.Results The location of lesions was 17 lesions (76%) in left lobe and 8 lesions (24%) in right lobe.According to pathological type,the imaging type of tumors were mass-type 15 cases (60%),infiltrative-type 5 cases (20%) and intracavitary-type 3 cases (12%).In 3 patients (12%) the tumors were not definable at any imaging phase.The shape of tumor was circular,lobulated,irregular.No contrast or mild contrast enhancement was observed in early phase and patchy,seperated or homogeneous enhancement in the central regions in the delayed phase of dynamic enhancement.The tumor was consisted of fibrous tissue,tumor cells and coagulative necrosis at the findings of histopathologic analysis.At the edge of tumor,the main components was living tumor cell that was the pathological base of early contrast enhancement.The delay contrast enhancement tended to be fibrosis,that mainly situated in the tumor central.Conclusion Dynamic contrast-enhanced CT was very important techniques for the correctly diagnosis of IHPCC.It is a typical feature of IHPCC that hypodensity of hepatic lesion on precontrast scan imaging,peripheral enhancement in the early stage and tumor central delayed contrast enhancement on the dynamic contrast-enhanced CT.更多还原