發(fā)布時(shí)間：2018-02-07 13:53

  本文關(guān)鍵詞： 膽囊腺瘤 癌變 磁共振成像　出處：《臨床放射學(xué)雜志》2016年01期 　論文類型：期刊論文

【摘要】：目的探討膽囊腺瘤(AG)及其局部癌變的MRI特征,以提高對(duì)該類疾病的診斷水平。方法回顧性分析經(jīng)手術(shù)病理證實(shí)的18例AG患者的MRI資料,其中5例局部癌變。由2名高級(jí)職稱影像診斷醫(yī)師分別獨(dú)立進(jìn)行圖像分析,觀察腫瘤的部位、數(shù)量、大小、形態(tài)、信號(hào)、強(qiáng)化程度、腫瘤與膽囊壁的關(guān)系及伴隨情況。結(jié)果 18例中位于膽囊體部10例,底部7例,頸部1例;單發(fā)病灶15例,多發(fā)3例。13例AG中,最大徑0.5 cm 2例,均呈乳頭狀,表面光整,動(dòng)脈期呈輕度均勻強(qiáng)化。0.5~1 cm 4例,乳頭狀和橢圓形各2例;表面光整1例,表面不光整并桑葚征3例;動(dòng)脈期輕度均勻強(qiáng)化1例,中度均勻強(qiáng)化3例。1 cm 7例,乳頭狀1例,橢圓形和菜花狀各3例;表面均不光整,并可見桑葚征;增強(qiáng)掃描動(dòng)脈期中度均勻強(qiáng)化6例,明顯強(qiáng)化1例。所有病灶均為窄基底,在T1WI和T2WI上為均勻等信號(hào)。5例AG局部癌變病灶(大小?),橢圓形1例,菜花狀4例;邊界光整1例,表面不光整并桑葚征4例;窄基底2例,寬基底3例。在T1WI和T2WI上均為均勻等信號(hào);增強(qiáng)掃描動(dòng)脈期明顯均勻強(qiáng)化2例,明顯不均勻強(qiáng)化3例。附著處膽囊壁局限性增厚3例,侵犯肝臟1例。結(jié)論膽囊內(nèi)窄基底腫塊伴桑葚征,應(yīng)考慮AG的診斷;若病灶局部基底增寬、桑葚征減少、明顯不均勻強(qiáng)化、附著處膽囊壁局限性增厚或周圍組織侵犯,需考慮AG癌變的可能。
[Abstract]:Objective to investigate the MRI features of adenoma of gallbladder (AGG) and its local carcinogenesis in order to improve the diagnostic level. Methods the MRI data of 18 patients with AG proved by operation and pathology were analyzed retrospectively. Among them, 5 cases of local carcinogenesis were analyzed independently by two senior image diagnostics doctors, and the location, quantity, size, shape, signal, enhancement degree of the tumor were observed. Results among 18 cases, 10 cases were located in the body of the gallbladder, 7 cases in the bottom, 1 case in the neck, 15 cases had single focus, 3 cases had multiple AG, 2 cases had the largest diameter 0.5 cm, all of them were papillary and smooth. Mild homogeneous enhancement was observed in 4 cases, papillary and elliptic in 2 cases, smooth surface in 1 case, and mulberry sign in 3 cases, mild homogeneous enhancement in 1 case, moderate homogeneous enhancement in 3 cases, papillary homogeneous enhancement in 7 cases, papillary pattern in 1 case, mild homogeneous enhancement in 1 case, moderate homogeneous enhancement in 3 cases, papillary pattern in 1 case. Oval and cauliflower shape in 3 cases, the surface was not only complete, but mulberry sign could be seen. In 6 cases of moderate homogeneous enhancement of arterial phase, 1 case was obviously enhanced. All lesions were narrow basal. Homogeneous signal intensity on T1WI and T2WI was found in 5 cases of AG local cancerous lesions (size? In 1 case, ellipse, 4 cases of cauliflower, 1 case of boundary light, 4 cases of mulberry sign, 2 cases of narrow base and 3 cases of wide base. The signal intensity was homogenous on T1WI and T2WI. There were 3 cases of obvious uneven enhancement, 3 cases of localized thickening of the gallbladder wall and 1 case of hepatic invasion. Conclusion the diagnosis of AG should be considered if the local basement of the lesion is enlarged, and the mulberry sign is decreased, conclusion there is a narrow basal mass in the gallbladder with mulberry sign. The possibility of AG carcinogenesis should be considered because of obvious uneven enhancement, localized thickening of gallbladder wall or invasion of surrounding tissues.
【作者單位】： 浙江大學(xué)醫(yī)學(xué)院附屬第二醫(yī)院放射科;浙江省新昌縣中醫(yī)院放射科;
【分類號(hào)】：R735.8;R445.2

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