摘要
目的:探讨CT诊断胆囊癌的价值,分析胆囊癌CT误诊原因,提高胆囊癌CT诊断水平。方法:分析手术病理证实的26例胆囊癌CT表现,术前均有CT平扫,其中19例进行了增强扫描。结果:胆囊癌女性多见,男女之比为1∶2.3,好发于50岁以上患者。本组26例胆囊癌CT表现特征可归纳为4型:①胆囊腔内肿块型2例,占7.7%(2/26);②胆囊壁增厚型4例,占15.4%(4/26);③胆囊周围浸润型9例,占34.6%(9/26);④混合型11例,占42.3%(11/26)。合并胆囊结石11例;肝脏直接受侵犯19例;肝内外胆管扩张13例;淋巴结转移15例;肝脏转移8例;累及胰和十二指肠8例;侵犯腹壁3例;侵犯胃窦2例;侵犯肝区结肠1例。CT术前正确诊断率为73.1%(19/26),CT术前误诊率为23.1%(6/26),漏诊1例,血清CA19-9阳性率80.8%(21/26)。结论:CT诊断胆囊癌有重要价值;仔细分析胆囊癌的CT征象和误诊原因,可提高诊断正确率。
Abstract
Objective: To evaluate the value of CT in the diagnosis of gallbladder carcinoma and analyse the CT misdiagnostic causes of gallbladder carcinoma, in order to improve the diagnostic rate. Methods: The CT findings of twenty-six patients with gallbladder carcinoma confirmed by operation and pathology were analysed. The misdiagnostic causes were analysed and compared CT images with operation. Results: Gallbladder carcinoma is more common in female than in male. It is often found over the age of 50 years old. Four type of gallbladder carcinoma were recognized: ①Intraluminal mass of gallbladder accounted for 7.7%(2/26); ②Thickening of the gallbladder wall accounted for 15.4%(4/26); ③Infiltrating tumor accounted for 34.6%(9/26); ④Mixed type accounted for 42.3%(11/26). The major CT findings were classified as follows: mass, thicken wall, intraluminal mass, mass with stone, bileduct dilatation, direct hepatic invasion, hepatic metastasis. Conclusion: CT has important value in assessing gallbladder carcinoma. Analysis of CT characteristic of gallbladder carcinoma and misdiagnostic causes are useful in improving the diagnostic rate.
关键词
胆囊肿瘤 /
体层摄影术 /
X线计算机 /
误诊
Key words
gallbladder neoplasms /
tomography /
X-ray computed /
diagnostic errors
陶学伟;王索宇;张新根.
胆囊癌的CT诊断及误诊分析[J]. 中国临床医学影像杂志. 2006, 17(4): 214-216
TAO Xue-wei;WANG Suo-yu;ZHANG Xin-gen.
CT diagnosis and misdiagnostic analysis of gallbladder carcinoma[J]. Journal of China Clinic Medical Imaging. 2006, 17(4): 214-216
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