【作者】 于仁旭；

【导师】 刘林祥； 马祥兴；

【作者基本信息】 泰山医学院 ， 影像医学与核医学， 2010， 硕士

【摘要】 目的肝门部胆管癌早期临床表现缺乏特异性,大多数患者就诊时已为中、晚期,预后较差。因此胆管癌仍是当前外科治疗上的难题。本研究通过对肝门部胆管癌的CT表现、临床及病理特征的比较为胆管癌的诊断及治疗、预后评价提供参考,通过研究增强CT对肝门部胆管显示情况；评价多层螺旋CT对肝门部胆管癌的诊断价值。材料与方法采用GE lightspeed或西门子Sensation16扫描仪,36例肝门部胆管癌患者行多层螺旋CT平扫及动态增强扫描,在ADW4.2工作站及西门子工作站对扫描数据进行后处理,并与手术及病理结果对照。结果肝门部胆管癌典型表现为肝内胆管扩张、肝门部肿块及肝门部胆管狭窄、中断,大部分肝门肿块以延迟强化为主；肿块均经手术切除、病理证实,结果显示28例为中高分化腺癌,8例为低分化腺癌。讨论肝门部胆管癌的初发症状多为梗阻性黄疸,外科治疗是目前唯一有效的方法。MSCT对肝门部胆管癌的定位及定性有重要意义,对制定手术方案也有重要作用。MSCT能够显示肝门部胆管癌的直接和间接征象,但在判断肿瘤周围浸润程度时有一定局限性。更多还原

【Abstract】 ObjectiveThere are no typical manifestations in the early stage of hilar cholangiocarcinoma. Most patients do not go to hospital until the advanced stage or late stage of disease. Hilar cholangiocarcinoma is still the sticky issue of surgical treatment. This study is to compare the CT findings, clinical and pathological character, to provide information for diagnose, treatment and prognosis, and to discuss the diagnostic value of MSCT in diagnosing hilar cholangiocarcinoma.Materials and Methods36 cases of hilar cholangiocarcinoma were examined with 16 slice CT scanner (GE lightspeed 16, USA, SIEMENS Sensation 16, Germany). All the cases were scanned with plain and dynamic contrast enhancement. The data were processed with workstation ADW4.2 or SIEMENS processing software. The diagnosis was conformed with surgical pathology.ResultsThe initial symptoms of hilar cholangiocarcinoma are intrahepatic cholangiectasis, mass of hepatic porta and narrow or absence of bile duct in the region of the hepatic porta. Most of mass shown delayed enhancement; 28 cases were high-differentiated gland cancer and eight cases were low-differentiated gland cancer in surgical pathology.ConclusionThe initial symptoms of hilar cholangiocarcinoma are obstructive jaundice, and the surgical treatment is the only effective method. MSCT plays an important role in qualitative analysis, determining the location and the surgical method. MSCT can show direct and indirect signs of hilar cholangiocarcinoma. But it also has limits in estimating infiltration of tumor.更多还原