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肝内胆管错构瘤影像学诊断

作者:杨 峰1 黄 博2 向 浩1 宋 萍1

所属单位:1.湖北医药学院附属襄阳医院放射科(湖北 襄阳 441000) 2.湖北省汉川市人民医院放射科(湖北 汉川 431600)

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摘要

目的探讨胆管错构瘤CT及MRI特 点,以提高对该病的诊断水平。方法 回 顾分析经本院证实的胆管错构瘤患者共13 例CT及MRI资料,观察病变在CT及MRI图像 上的分布、大小、形态及强化特点。结果 胆管错构瘤在CT平扫主要表现为肝内低密 度的囊性病灶,大小不等,形态各异,边 界部分清楚,部分不清楚,增强扫描无 明显强化,MRI主要表现为长T1长T2改变 (T1WI上病变信号低于肝实质,T2WI病灶 显示为明显的高信号),增强扫描病灶未 见明显强化,部分病灶出现边缘强化及结 节状强化,MRCP成像显示肝内囊性病变与 肝内胆管不相通,肝内胆管树分支未见明 显异常。结论 胆管错构瘤的CT及MRI表现 有一定的特征性,有助于对该病的诊断, 最终确诊有赖于采用活体组织进行病理学 检查。

Objective To discuss CT and MRI findings of multiple hepatic biliary hamartoma in order to improve the umderstanding of this disease. Methods The CT and MRI findings of multiple biliary hamartoma proved by biopsy and pathology in 13 cases were retrospectively analyzed. Then observing the lesions in CT and MRI images on the distribution,size, morphology and enhancement characteristics. Results CT scan showed multiple lesions of hepatic biliary hamartoma were low density,contrast enhanced scan showed no enhancement. Lesions were long signal intensity on T1WI and T2WI, and enhanced scanning had no obvious enhancement, some lesions appeared edge enhancement and nodular enhancement. MRCP showed the multiple intrahepatic cystic high signal which was not connected with visible biliary tree. Conclusion There are certain characteristic in CT and MRI findings, which is helpful in the diagnosis of the disease, the final diagnosis depends on pathological examination was performed by living tissue.

【关键词】胆管错构瘤;体层摄影术,X线计算机;磁共振成像

【中图分类号】R575.7

【文献标识码】A

【DOI】 10.3969/j.issn.1672-5131.2015.04.22

前言

胆管错构瘤是由于胚胎发育过程中胆管板向胆管的转化发生障 碍,吸收不充分所导致的错构性病变。是Von Meyenburg在1918年首先 描述的,故该病又称为Von Meyenburg综合征,简称VMC,临床上较为 少见。本文回顾性分析经过临床穿刺活检病理证实的胆管错构瘤的CT 及MRI表现,结合文献对本病的病理及影像学特点进行讨论,以提高对 本病的认识。