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目的:探讨周围型胆管细胞癌CT动态增强扫描征象的诊断价值及其病理基础。方法:20例经手术证实的肝内周围型胆管细胞癌术前均做了CT平扫,其中18例做了CT动态增强扫描,20例均做病理检查。进行术前CT与病理标本对应切面的对照研究,观察不同CT征象的病理改变。结果:发现病灶内的延迟强化区CT表现具有一定特异性,病理为大量纤维组织伴少量散在腺癌组织,部分病灶延迟强化区内的无强化区为凝固性坏死或同时含有大量黏液的存活癌组织。结论:周围型胆管细胞癌的CT动态增强扫描征象对其诊断及在与肝细胞型肝癌等多种常见肝肿瘤的鉴别中有重要意义。
Objective: To investigate the diagnostic value and pathological basis of CT dynamic contrast-enhanced scanning in peripheral cholangiocarcinoma. Methods: Twenty cases of intrahepatic peripheral cholangiocarcinoma confirmed by surgery were scanned with CT before operation. Among them, 18 cases underwent CT dynamic contrast-enhanced scan and 20 cases underwent pathological examination. Preoperative CT and pathological specimens of the corresponding section of the control study to observe the pathological changes of different CT signs. Results: CT findings of delayed enhancement in the lesion showed a certain specificity. The pathology was a large number of fibrous tissue with a small amount of scattered adenocarcinoma tissues. Some of the lesions with no delayed enhancement in the area were coagulation necrosis or survivors with mucus organization. Conclusion: CT dynamic contrast-enhanced scanning of peripheral cholangiocarcinoma is of great significance for its diagnosis and differential diagnosis of many common liver tumors such as hepatocellular carcinoma.