本文關(guān)鍵詞： 肝臟 膽管細(xì)胞癌 肝膿腫 體層攝影術(shù) X線計(jì)算機(jī) 磁共振成像　出處：《國(guó)際醫(yī)學(xué)放射學(xué)雜志》2016年05期 　論文類型：期刊論文

【摘要】：目的探討不典型肝內(nèi)膽管細(xì)胞癌合并肝膿腫的影像表現(xiàn)特征和診斷要點(diǎn)。方法回顧性分析1例經(jīng)手術(shù)病理證實(shí)為肝內(nèi)膽管細(xì)胞癌合并肝膿腫病人的臨床資料、影像表現(xiàn)特征并復(fù)習(xí)相關(guān)文獻(xiàn)。結(jié)果 MDCT平掃顯示巨大不規(guī)則腫物,累及肝左葉及部分右前葉,腫物呈分葉狀,內(nèi)部密度不均,鄰近血管無受侵、肝包膜無凹陷征;增強(qiáng)CT檢查動(dòng)脈期顯示腫物呈多結(jié)節(jié)融合狀,病灶邊緣及內(nèi)部各結(jié)節(jié)呈明顯環(huán)形強(qiáng)化,門靜脈期及平衡期腫物強(qiáng)化仍較明顯。肝臟MRI平掃腫物呈不規(guī)則形稍長(zhǎng)T1、稍長(zhǎng)T2信號(hào)影,于DWI序列上顯示不均勻較明顯高信號(hào),增強(qiáng)掃描表現(xiàn)類似于增強(qiáng)CT表現(xiàn),另于MRI增強(qiáng)掃描門靜脈期及平衡期可見腫物內(nèi)局部區(qū)域呈分房狀表現(xiàn),增強(qiáng)程度更明顯。結(jié)論不典型肝內(nèi)膽管細(xì)胞癌合并肝膿腫兼具兩種病變的影像表現(xiàn)。正確診斷需結(jié)合臨床、實(shí)驗(yàn)室檢查、超聲表現(xiàn)并注重影像表現(xiàn)的細(xì)節(jié)信息。
[Abstract]:Objective to investigate the imaging features and diagnostic features of atypical intrahepatic cholangiocarcinoma with liver abscess. Methods A case of intrahepatic cholangiocarcinoma with liver abscess proved by operation and pathology was retrospectively analyzed. Results MDCT plain scan showed huge and irregular masses involving Zuo Ye of liver and part of right anterior lobe. The masses were lobular with uneven internal density and no invasion of adjacent blood vessels. There was no indentation in hepatic capsule. Contrast-enhanced CT showed that the tumor was multi-nodular fusion in arterial phase, and the nodules in the edge and inside of the lesion were obviously circular enhancement. The enhancement of tumor in portal vein and balance phase was still obvious. MRI plain scan showed irregular shape slightly longer T _ 1 and slightly longer T _ 2 signal intensity, and showed heterogeneity and higher signal intensity on DWI sequence. Contrast-enhanced CT findings were similar to those of contrast-enhanced CT, and the local areas of tumors in portal phase and equilibrium phase of MRI enhanced scanning showed sectional-like manifestations. Conclusion atypical intrahepatic cholangiocarcinoma combined with liver abscess has two kinds of imaging manifestations. The correct diagnosis should be combined with clinical, laboratory, ultrasonic findings and pay attention to the details of the imaging findings.
【作者單位】： 天津市第三中心醫(yī)院 天津市肝膽研究所 天津市人工細(xì)胞重點(diǎn)實(shí)驗(yàn)室 衛(wèi)生部人工細(xì)胞工程技術(shù)研究中心 天津市血液灌流企業(yè)重點(diǎn)實(shí)驗(yàn)室 天津醫(yī)科大學(xué)三中心臨床學(xué)院;
【分類號(hào)】：R735.8;R445.2;R730.44
【正文快照】： 肝內(nèi)膽管細(xì)胞癌是一種較常見的肝臟原發(fā)惡性腫瘤,屬腺癌,起源于末梢膽管上皮或肝內(nèi)小膽管,好發(fā)于老年人[1]。肝膿腫是肝組織局限性化膿性炎癥,典型的肝膿腫在CT和MRI增強(qiáng)檢查中較易 正確診斷[2]。然而,不典型的肝膿腫在影像診斷中需與肝內(nèi)膽管細(xì)胞癌鑒別。本文就1例膽管細(xì)胞

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