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肝脏胆管囊腺瘤及囊腺癌八例临床MRI表现

肖渤瀚1,尹璐1,刘伯杨1,2   

  1. 1. 天津医科大学附属肿瘤医院
    2.
  • 收稿日期:2010-09-13 修回日期:2011-01-16 出版日期:2011-09-15 发布日期:2011-09-15
  • 通讯作者: 肖渤瀚

MRI findings of hepatic biliary cystadenoma and cystadenocarcinoma

  • Received:2010-09-13 Revised:2011-01-16 Published:2011-09-15 Online:2011-09-15
  • Contact: Bo-Han XIAO

摘要: 【摘要】 目的 分析肝脏胆管囊腺瘤及囊腺癌的MRI表现,讨论 MRI对其诊断价值。方法 回顾性分析手术病理证实的肝脏胆管囊腺瘤(2例)及囊腺癌(6例)的MRI表现,并与病理所见相对照。结果 8例均为单发囊性肿物。囊内液体成分多样,在MRI上表现为不同信号强度。囊腺瘤和囊腺癌各1例有囊内出血。2例囊腺瘤边缘光滑,囊壁及分隔呈均匀线样,增强后无明显强化或仅轻度强化。6例囊腺癌中囊壁及分隔不规则,其中4例可见壁结节。增强后实性成分强化明显,多以门脉期及延迟期强化为著,仅2例病变内壁结节以动脉期强化为著。2例囊腺癌相邻肝内胆管扩张,其中1例与胆管相通。多数囊腺癌边缘光滑锐利,仅1例边缘模糊,术后出现复发。结论 MRI可显示肝脏胆管囊腺瘤及囊腺癌的特征性形态学表现,在术前诊断有重要作用。囊腺癌中强化实性成分明显多于囊腺瘤,囊内出血及胆管受累亦多见于囊腺癌中。囊腺癌边界模糊提示预后不良。

关键词: 胆管肿瘤, 囊腺瘤, 囊腺癌, 磁共振成像

Abstract: 【Abstract】 Objective : To analyze the features of hepatic biliary cystadenoma and cystadenocarcinoma on MRI, and to discuss the diagnostic value of MRI in the diseases. Methods:The MRI features of 2 cases of cystadenoma and 6 cases of cystadenocarcinoma proved by pathology were analyzed retrospectively and correlated with the pathologic findings. Results:All of 8 cases were revealed as solitary cystic lesions. Variant contents in the intracystic fluid showed different signal intensity on MRI. Hemorrhagic fluid was seen in one cystadenoma and one cystadenocarcinoma respectively. The 2 cases of cystadenoma were well-defined, with smooth cystic wall and internal septa, and showed no enhancement or slightly enhancement after contrast. Irregular thickening in cystic wall and internal septa were found in these cystadenocarcinomas, and mural nodules were found in the 4 cases. After contrast,the solid parts were obviously enhanced, particularly in port vein phase and delay phase, but for the 2 cases which were enhanced particularly in arterial phase. Ductal dilatation near the lesions was seen in 2 cases, furthermore communication between the lesion and the bile duct was seen in one of them. The margins of the cystadenocarcinoms were mostly smooth, except for that of one recured after resection. Conclusions: MRI can reveal the characteristic morphological features of hepatic biliary cystadenoma and cystadenocarcinoma, and play an important role in the diagnosis before the operation. Solid parts enhanced can be seen much more frequently in cystadenocarcinoma than in cystadenoma. Hemorrhagic internal fluid and involved bile ducts are also more common in cystadenocarcinoma. The cystadenocarcinomas with ill-defined margins may have unfavourable prognosis.

Key words: Bile duct neoplasm, Cystadenoma, Cystadenocarcinom, MRI