原发性胆囊癌的螺旋CT诊断

目的探讨胆囊癌的螺旋CT表现,以提高对本病的认识.方法回顾性分析23例经手术病理证实的胆囊癌的临床及CT表现.23例均行CT平扫及增强双期扫描.扫描延迟时间为20S-25S和60S-65S,对比剂用量100ml,注射流率3ml/s.结果胆囊癌的主要CT表现有:①胆囊壁局限性增厚或弥漫性不规则增厚7例;②胆囊区或胆囊腔内肿块16例;③合并胆囊结石6例;④直接侵犯肝脏11例.肝内转移4例.肝内外胆管扩张9例;⑤肝门及胰腺周围淋巴结转移11例.结论中晚期胆囊癌具有较典型的CT表现,80%以上的病人术前可以确诊.CT可以明确病变部位.分型及扩散范围,是一种重要的影像学检查方法,但早期发现仍存在一定困难.

Diagnosis of Primary Gallbladder Carcinoma by Spiral CT

Objective: To study the CT features of primary gallbladder carcinoma. Methods :23 patients (9 males and 14 females, ranged in age from 36 to 72 years) with gallbladder carcinoma by pathology were analyzed retrospectively. All patients underwent abdominal precontrast and dual phases contrast. The cortical phase scan were started at 20s-25s after the injection of contrast medium and the parenchymal phase scan were started at 60s-65s.The dose of contrast medium was 100ml with 3ml/s injection rate. Results :The main spiral CT appearances were:(1) The wall of the gallbladder localized or perfuse irregular thickening (n=7);(2) Mass in the region of gallbladder and intra-cavity (n=16);(3)Concurrent cholecysto-lithiasis (n=6);(4) Liver invasion (n=11) and metastasis (n=4) and intra-and extra-liver cholangiectasis (n=9); (5) Liver hilar and peripancreatic lymph node metastasis (n=11).Conclusion :Mid-late gallbladder carcinoma has some typical CT is an important means for identifying the location, the categorical, and invasive extent of the lesions, but the early diagnosis was still difficult.