目的 提高MRI诊断肝内周围型胆 管细胞癌(IHPCC)的正确率。方法 回顾性 分析经手术或穿刺病理证实的12例IHPCC 的MRI资料，所有病例均经平扫和动态增 强扫描。着重从各序列信号特点及动态 增强病灶强化特征等方面进行分析。结 果 12例患者共发现14个病灶，2例伴有卫 星灶，2例同时伴发肝内血管瘤；10个病 灶呈类圆形，4个病灶呈不规则形；7个病 灶位于肝包膜下， 3个病灶跨叶生长。所 有病灶T1WI主体呈低或稍低信号，T2WI呈 高或稍高信号(11个病灶中心可见斑片状 或星芒状低信号影)；DWI病灶呈不均匀 稍高信号(10个病灶呈不规则环形稍高信 号，病灶中心呈等低信号)。增强后10个 病灶于动脉期呈周边不规则环形强化，门 静脉及延迟期强化范围向中心扩展；3个 病灶动脉期周边及中心均不规则强化，门 脉期及延迟期强化范围进一步扩大。1个 病灶由于体积较小，强化特征不明显。11 个病灶可伴随周边胆管扩张，其中6个病 灶内可见胆管扩张；8个病灶周边肝组织 于动脉期呈云雾样强化，9个病灶邻近肝 被膜皱缩，3个病灶所在肝叶萎缩。结论 IHPCC的MRI表现具有一定特征性，综合分 析各序列的信号特点、强化特征及其伴随 征象能提高IHPCC诊断的准确率。

Objective To improve the accuracy of MRI in diagnosis of intrahepatic peripheral cholangiocarcinoma (IHPCC). Methods MRI data of 12 cases with IHPCC confirmed by surgery or biopsy were retrospectively analyzed. All the cases underwent plain and dynamic contrast-enhanced MR scanning. Signal intensity of the lesions in different sequences and the dynamic enhancement pattern were emphatically analyzed. Results A total of 14 lesions were found in 12 cases, among which 2 cases were accompanied with satellite lesions and other 2 cases with hepatic hemangioma. Ten lesions were round while 4 lesions showed irregular shape. Seven lesions were located at hepatic subcapsule area, and 3 lesions covered multiple lobes. All the lesions showed hypointensity in T1WI and hyperintensity in T2WI (11 lesions with patchy or asteroid hypointense areas). The lesions showed inhomogeneous slightly high signal in DWI (10 lesions showed irregular ring slightly high signal with low signal in the center). Ten lesions showed irregular peripheral circular enhancement in the arterial phase, extended concentric enhancement in the portal venous and delayed phases. Three lesions showed both peripheral and central enhancement in the arterial phase and extended enhancement in the portal venous and delayed phases. One lesion showed due to unobvious enhancement due to its smaller size. Eleven lesions were accompanied with peripheral bile duct dilatation, six among them with intratumoral visible bile duct dilatation. Liver tissue around 8 lesions showed cloudy enhancement in the arterial phase. Adjacent liver capsule shrinkage was found in 9 lesions. Liver lobe atrophy was demonstrated in 3 lesions. Conclusion MRI features of IHPCC were characteristic. Comprehensive analyzation of signal intensities in different sequences, enhancement patterns as well as accompanying signs can improve the diagnostic accuracy of IHPCC.