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目的总结胆囊癌的多层螺旋CT(multi-slice spiral computed tomography,MSCT)表现,分析误诊原因,以期提高胆囊癌的诊断准确率。方法回顾性分析经手术组织病理证实51例胆囊癌患者的MSCT影像资料。结果与手术组织病理结果进行对照,MSCT术前诊断胆囊癌46例,误诊为慢性胆囊炎3例、胆囊息肉1例、原发性肝癌1例;46例胆囊癌患者MSCT表现为厚壁型23例,结节型12例,肿块型11例;合并胆囊结石胆囊炎34例,侵犯邻近肝脏17例、邻近脏器15例,发生肝脏转移9例,肝门部淋巴结转移5例,腹膜后淋巴结转移4例,有腹腔积液4例。结论胆囊癌依据MSCT典型直接及间接征象可明确诊断,误诊与影像表现不典型、间接征象不明显有关。
Objective To summarize the manifestations of multi-slice spiral computed tomography (MSCT) in gallbladder carcinoma and analyze the causes of misdiagnosis in order to improve the diagnostic accuracy of gallbladder carcinoma. Methods The MSCT images of 51 patients with gallbladder carcinoma confirmed by histopathology were retrospectively analyzed. The results were compared with the histopathological findings. 46 cases of gallbladder carcinoma were diagnosed before MSCT, 3 cases were diagnosed as chronic cholecystitis, 1 case of gallbladder polyps, 1 case of primary hepatocellular carcinoma. MSCT of 46 cases of gallbladder carcinoma was thick-wall type 23 Cases, nodular type in 12 cases, mass type in 11 cases; complicated with cholecystolithiasis in 34 cases, 17 cases of adjacent liver violations, 15 cases of adjacent organs, liver metastases in 9 cases, hilar lymph node metastasis in 5 cases, retroperitoneal lymph nodes Metastasis in 4 cases, 4 cases of ascites. Conclusions Gallbladder carcinoma can be diagnosed according to the typical direct and indirect signs of MSCT. Misdiagnosis and atypia are not typical of the gallbladder carcinoma. The indirect signs are not obviously related.