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1、中华放射学杂志2002年6月第36卷第6期ChinJRadiol,June2002,Vol36,No.6·527··消化系统放射学·胆囊腺肌增生症的CT检查技术和表现彭卫军周康荣李轫晨施伟斌陈惠明【摘要】目的描述胆囊腺肌增生症的CT表现,特别是多期增强扫描和口服胆囊对比剂后的CT表现特点,提高对本病CT表现的认识。方法经手术病理证实的11例胆囊腺肌增生症,其中男5例,女6例。年龄38～56岁,平均43岁。检查采用CT平扫、动态增强、多期增强扫描技术和口服胆囊对比剂后CT扫描技术。结果11例中CT术前诊断胆囊腺肌增生症7例,其中,弥漫型3例,节段型1例,基底型3例;
2、误诊为慢性胆囊炎2例,胆囊癌1例,CT未见异常1例。CT表现为胆囊壁弥漫或局限性增厚,内外壁较光整,肝胆交界清晰。增强特点为动脉期病变区的黏膜及部分黏膜下明显强化,在门脉期和延迟期,强化沿黏膜面向浆膜面扩展,全层均匀或不均匀显著强化。特征性CT表现为口服胆囊对比剂后胆囊内Rokitansky2Aschoff窦充盈对比剂,服脂肪餐后显示“光环征”。结论口服胆囊对比剂后CT检查对胆囊腺肌增生症有定性诊断价值,CT多期扫描对胆囊腺肌增生症有较高的诊断准确性,二者结合对胆囊壁增厚性病变的诊断和鉴别诊断有较高的价值。【关键词】胆囊疾病;腺瘤;体层摄影术,X线计算机;诊断显像
3、ComputedtomographicmethodsandfindingsinadenomyomatosisofthegallbladderPENGWeijun,ZHOUKangrong,LIRenchen,SHIWeibin,CHENHuiming.DepartmentofRadiology,ZhongshanHospital,FudanUniversity,Shanghai200032,China【Abstract】ObjectiveTodescribethecharacteristicCTimagingofadenomyomatosisofgallbladd
4、erandtoimprovethediagnosticknowledgeofthedisease.MethodsEleven(5malesand6females,meanage=43years)patientswithadenomyomatosisofgallbladder(4diffuse,2segmental,and5fundal)confirmedbyhistopathologyandperformedbyCTexaminationincludingplain,dynamicormultiphaseenhancementand/ororalcholegrap
5、hicagentwerereviewed.ResultsCorrectdiagnosiswasmadein7of11patients(3diffuse,1segmental,and3fundal).CTfindingsincludedsegmentalordiffusegallbladderwallthickeningintheinvolvedarea,associatedwithwelldefinedandregularbordersatbothoftheinnerandouterlayers.SignificantCTfindingsofthisentityw
6、eremarkedenhancementofwalllayersduringtriphasecontrastCTscanning,especiallyatdelayedscans.Rokitansky2AschoffsinuseswereclearlyshownbyCT,presentingascharacteristic“aureola”sign,whenperformedwithapplicationofacholegraphicagent.ConclusionUnderstandingtheCTfindingsandusingtheoptimalmethod
7、s,wecanuseCTscanasavaluablemethodtohelpmakethediagnosisinmostcasesofadenomyomatosis.【Keywords】Gallbladderdiseases;Adenomy;Tomography,X2raycomputed;Diagnosticimaging胆囊腺肌增生症(adenomyomatosisofthe材料与方法gallbladder)是导致胆囊壁增厚的胆囊疾病之一,在胆囊疾病的诊断上,常常存在与胆囊其他疾病特别一、临床资料是与胆囊癌鉴别诊断的问题。本病过去主要依靠口1986年8月至2
8、001年5
