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1、中华放射学杂志2015年2月第49卷第2期ChinJRadiol,February2015,Vol.49,No.2·113··腹部放射学·无胆管扩张的肝内胆管细胞癌的MRI特征及其病理基础丁怀银孙晓东朱西琪杜超沈娟周群李代新许传军袁莉莉李怀花刘杜先宋红参【摘要】目的探讨无胆管扩张的肝内胆管细胞癌的MRI特征及其病理基础。方法回顾性分析经手术病理证实为周围型肝内胆管细胞癌，且病灶为直径≤3cm的肝内孤立结节，术前行MRI检查的12例患者资料。患者均行腹部MRI平扫及动态增强扫描。观察患者的MRI表现，并与病理结果进行对照。结果MRI平扫T1WI为低信号8例、混杂性低信号4例；T
2、2WI为高信号8例、混杂性高信号4例。1例病灶动脉期明显强化，门静脉期及延迟期呈等信号；病理诊断为低分化胆管腺癌。10例动脉期呈不均匀强化或环形强化，其中3例动脉期病灶周边呈薄环形强化，门静脉期呈低信号，延迟期呈等信号。周边薄环强化组织对应的病理改变为成活肿瘤细胞，中心延迟强化组织为大量纤维结缔组织。4例动脉期病灶周边呈厚环形强化，3例门静脉期及延迟期呈低信号，1例延迟强化。厚环形强化对应的病理改变为成活肿瘤细胞，中心延迟强化组织为大量纤维结缔组织，少量坏死组织。3例动脉期呈岛状强化或不均匀强化，对应的病理改变为肿瘤组织及少量纤维结缔组织、部分坏死组织。1例3期扫描肿瘤均无强
3、化，对应的病理改变为肿瘤明显囊性扩张、出血、坏死，肿瘤与正常肝组织间见成活肿瘤细胞。结论无胆管扩张的肝内胆管细胞癌MRI表现具有一定特征性，不同MRI表现具有其病理基础。【关键词】胆管肿瘤；磁共振成像；病理学MRIcharacteristicsandpathologicalcorrelationregardingtheintrahepaticcholangiocarcinomawithoutcholangiectasisDingHuaiyin*,SunXiaodong,ZhuXiqi,DuChao,ShenJuan,ZhouQun,LiDaixin,XuChuanjun,Yu
4、anLili,LiHuaihua,LiuDuxian,SongHongshen.*DepartmentofRadiology,Second
AffiliatedHospitalofSoutheastUniversity,Nanjing210003,ChinaCorrespondingauthor:SunXiaodong,Email:professor0519@163.com【Abstract】ObjectiveTostudyingtheMRfindingsandpathologyofperipheralsmallintrahepatic
cholangiocarcinomaa
5、ndimprovingtheunderstandingofperipheralsmallcholangiocarcinomawithno-bile
ductdilatation.MethodsAretrospectiveanalysisof12patientswithintrahepaticperipheral
cholangiocarcinomawhichwereconfirmedbysurgeryandpathology,allpatientswereexaminedby
abdominalMRIwithoutandwithcontrast.Correlationwasm
6、adewithgrosspathologyandsurgicalpathologicalspecimen.ResultsOnT1WI,therewere4casesofcomplexlowsignalintensityand8casesoflowsignalintensity.OnT2WI,therewere8casesofhighsignalintensityand4casesofcomplexhighsignal
intensity.EnhancedMRIshowed:markednidusenhancementonarterialphasein1case,andthe
7、pathologicaldiagnosiswaspoorlydifferentiatedadenocarcinoma.Inhomogeneousenhancementorannular
enhancementwereseenin10casesonarterialphase,3ofthesecasesshowedthinannularenhancementon
arterialphase,lowsignalintensityonportalvenousphaseandisointensityondelay
