肝内胆管细胞癌的CT表现与病理对照分析(1)
摘 要：目的 对比研究肝内胆管细胞癌的CT表现与临床病理特征。方法 回顾性分析经病理证实的肝内胆管细胞癌19例，均行CT平扫和动态增强扫描。将肝内胆管细胞癌CT表现及病理进行对照分析。结果 肿瘤在CT上表现为不规则软组织肿块，伴远侧胆管扩张，病理上肿瘤外周主要由大量恶性肿瘤细胞分布，中央区由大量纤维组织构成，形成肿瘤延迟期强化的病理基础。临近肝包膜的肿块引起癌脐征。结论 肝内胆管细胞癌的临床表现缺乏特异性，动态增强是CT诊断和鉴别诊断要点。增生纤维组织形成肿瘤延迟强化的病理基础；排列成腺管的癌细胞引起肿瘤早期强化。肿块边缘不清，增强后边缘不规则，反映肿瘤多无包膜的病理特征。肿瘤浸润生长，内部大量纤维组织存在，出现牵拉，CT表现为癌脐征。
关键词：胆管细胞癌；病理学；体层摄影术；X线计算机
中图分类号：R735.8 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.10.053
, 百拇医药
文章编号：1006-1959(2018)10-0153-03
Analysis of CT Findings and Pathology of Cholangiocarcinoma
MA Shu-hui，LIU Lin-feng，ZHANG Li-hua，YANG Jian
(Department of Radiology，Yinchuan Third People's Hospital，Yinchuan 750004，Ningxia，China)
Abstract：Objective To compare the CT findings and clinicopathological features of cholangiocarcinoma.Methods Retrospective analysis of 19 cases of pathologically confirmed cholangiocarcinoma，CT scan and dynamic contrast scan were performed.The CT findings and pathology of cholangiocarcinoma were analyzed and compared.Results The tumor showed irregular soft tissue mass on CT， with distal bile duct dilatation.Pathologically，the tumor periphery was mainly distributed by a large number of malignant tumor cells， and the central region was composed of a large number of fibrous tissues，which formed the pathological basis for enhanced tumor delay period.The tumor adjacent to the liver capsule causes a cancer umbilicus sign.Conclusion The clinical manifestations of cholangiocarcinoma are lack of specificity.Dynamic enhancement is the main point of CT diagnosis and differential diagnosis. Hyperplasia of fibrous tissue forms the pathological basis for delayed tumor enhancement；cancer cells lined in ducts cause early tumor enhancement.The edge of the mass was unclear，and the enhanced edge was irregular，reflecting the pathological features of the tumor without more capsules.Tumor infiltrates and grows，a large number of internal fibrous tissues are present，traction occurs，and CT manifests as a cancerous umbilicus sign.
, http://www.100md.com
Key words：Cholangiocarcinoma；Pathology；Tomography；X-ray computer
肝內胆管细胞癌(cholangiocarcinoma)起源于肝内胆管上皮细胞的一种少见恶性肿瘤，约占全部胆管细胞癌的10%和肝内恶性肿瘤的5%～10%。其临床表现复杂多样，易与肝内其它占位性病变混淆，为进一步提高肝内胆管细胞癌CT征象的认识，作者收集经病理证实的肝内胆管细胞癌19例，重点探讨CT表现及其病理基础。
1资料与方法
1.1一般资料 回顾性分析2012年11月～2017年11月银川市第三人民医院经病理学证实的肝内胆管细胞癌19例，其中男8例，女11例，年龄46～72岁，平均年龄(55.01±1.50)岁。主要症状：上腹痛7例，伴发热3例，伴有胆管内结石2例，体重下降4例，腹部包块伴黄疸2例，乏力纳差4例，无明显症状2例。所有病例均经病理学证实。
1.2方法 CT采用GE公司的BrightSpeed Edge Select或Philips Intelligence64排128层设备。CT平扫后静脉团注(2.5～3 ml/s)非离子型对比剂100 ml后，30 s、60 s及3～5 min分别行动脉期、门脉期、延迟期扫描，扫描层厚5 mm，2～3 mm重建。, http://www.100md.com(马淑辉 柳林峰 张丽花)
关键词：胆管细胞癌；病理学；体层摄影术；X线计算机
中图分类号：R735.8 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.10.053
, 百拇医药
文章编号：1006-1959(2018)10-0153-03
Analysis of CT Findings and Pathology of Cholangiocarcinoma
MA Shu-hui，LIU Lin-feng，ZHANG Li-hua，YANG Jian
(Department of Radiology，Yinchuan Third People's Hospital，Yinchuan 750004，Ningxia，China)
Abstract：Objective To compare the CT findings and clinicopathological features of cholangiocarcinoma.Methods Retrospective analysis of 19 cases of pathologically confirmed cholangiocarcinoma，CT scan and dynamic contrast scan were performed.The CT findings and pathology of cholangiocarcinoma were analyzed and compared.Results The tumor showed irregular soft tissue mass on CT， with distal bile duct dilatation.Pathologically，the tumor periphery was mainly distributed by a large number of malignant tumor cells， and the central region was composed of a large number of fibrous tissues，which formed the pathological basis for enhanced tumor delay period.The tumor adjacent to the liver capsule causes a cancer umbilicus sign.Conclusion The clinical manifestations of cholangiocarcinoma are lack of specificity.Dynamic enhancement is the main point of CT diagnosis and differential diagnosis. Hyperplasia of fibrous tissue forms the pathological basis for delayed tumor enhancement；cancer cells lined in ducts cause early tumor enhancement.The edge of the mass was unclear，and the enhanced edge was irregular，reflecting the pathological features of the tumor without more capsules.Tumor infiltrates and grows，a large number of internal fibrous tissues are present，traction occurs，and CT manifests as a cancerous umbilicus sign.
, http://www.100md.com
Key words：Cholangiocarcinoma；Pathology；Tomography；X-ray computer
肝內胆管细胞癌(cholangiocarcinoma)起源于肝内胆管上皮细胞的一种少见恶性肿瘤，约占全部胆管细胞癌的10%和肝内恶性肿瘤的5%～10%。其临床表现复杂多样，易与肝内其它占位性病变混淆，为进一步提高肝内胆管细胞癌CT征象的认识，作者收集经病理证实的肝内胆管细胞癌19例，重点探讨CT表现及其病理基础。
1资料与方法
1.1一般资料 回顾性分析2012年11月～2017年11月银川市第三人民医院经病理学证实的肝内胆管细胞癌19例，其中男8例，女11例，年龄46～72岁，平均年龄(55.01±1.50)岁。主要症状：上腹痛7例，伴发热3例，伴有胆管内结石2例，体重下降4例，腹部包块伴黄疸2例，乏力纳差4例，无明显症状2例。所有病例均经病理学证实。
1.2方法 CT采用GE公司的BrightSpeed Edge Select或Philips Intelligence64排128层设备。CT平扫后静脉团注(2.5～3 ml/s)非离子型对比剂100 ml后，30 s、60 s及3～5 min分别行动脉期、门脉期、延迟期扫描，扫描层厚5 mm，2～3 mm重建。, http://www.100md.com(马淑辉 柳林峰 张丽花)