CT在黄色肉芽肿性胆囊炎诊断中的价值

沈训泽; 吴瑾秀; 周合山; 张广强; 杨斌

中国临床医学影像杂志 ›› 2007, Vol. 18 ›› Issue (2) : 123-125.

论著

CT在黄色肉芽肿性胆囊炎诊断中的价值

沈训泽1，吴瑾秀2，周合山3，张广强2，杨斌3

作者信息 +

Evaluation of CT in the diagnosis of xanthogranulomatous cholecystitis

SHEN Xun-ze1, WU Jin-xiu2, ZHOU He-shan3, ZHANG Guang-qiang2, YANG Bin3

Author information +

文章历史 +

摘要

目的：评价CT对黄色肉芽肿性胆囊炎（XGC）的诊断及与壁厚型胆囊癌鉴别诊断的价值。方法：测量13例XGC与19例壁厚型胆囊癌的胆囊壁最大厚度，并对其以下CT征象进行分析：①胆囊壁间低密度结节或低密度带，②黏膜线，③胆囊内壁改变情况，④肝内浸润，⑤肝内胆管扩张，⑥腹膜后淋巴结肿大。结果：13例XGC平均壁厚（24.7±16.0）mm，10例病灶区出现低密度结节或低密度带，8例存在黏膜线，8例病变处胆囊内壁光整，5例出现肝内浸润，1例出现肝内段胆管扩张，均无腹膜后淋巴结肿大；而19胆囊癌平均壁厚（18.3±8.6）mm，6例病灶区出现低密度结节或低密度带，该6例且均存在黏膜线，8例病变处胆囊内壁光整，7例出现肝浸润，12例出现肝内段胆管扩张，4例腹膜后淋巴结肿大。结论：增厚的胆囊壁间出现低密度结节或低密度带，肝内胆管无扩张，是XGC诊断与鉴别诊断的关键CT征象。

Abstract

Objective: To access the value of CT in the diagnosis of xanthogranulomatous cholecystitis(XGC) and its differentiation from thick-wall gallbladder carcinoma. Methods: The maximum thickness of the cystic wall was measured in 13 cases of XGC and 19 cases of thick-wall gallbladder carcinoma. The following CT features were analyzed and recorded:①intramural hypoattenuated nodules or bands of the gallbladder; ②mucosal line; ③appearances of the cystic inner wall; ④infiltration of the liver; ⑤dilation of intrahepatic bile duct; ⑥retroperitoneal lymphadenopathy. Results: The mean thickness of the cystic wall for XGC was (24.7±16.0)mm and (18.3±8.6)mm for gallbladder carcinoma. Intramural hypoattenuated nodules were seen in 10 patients with XGC and 6 with gallbladder carcinoma. Mucosal line was observed in 8 patients with XGC and 6 with gallbladder carcinoma. Inner wall of the gallbladder was even in 8 patients with XGC and 8 with gallbladder carcinoma. Hepatic involvement was seen in 5 patients with XGC and 7 with gallbladder carcinoma. Expansion of intrahepatic bile ducts existed in 1 patient with XGC but in 12 with gallbladder carcinoma. Retroperitoneal lymphadenopathy was observed in 4 patients with gallbladder carcinoma but none with XGC. Conclusion: Intramural hypoattenuated nodules or bands in thickened cystic wall without dilation of intrahepatic bile duct is the most valuable CT features for diagnosis of XGC and its’ differentiation from gallbladder carcinoma.

导出引用

沈训泽;吴瑾秀;周合山;张广强;杨斌. CT在黄色肉芽肿性胆囊炎诊断中的价值[J]. 中国临床医学影像杂志. 2007, 18(2): 123-125

SHEN Xun-ze;WU Jin-xiu;ZHOU He-shan;ZHANG Guang-qiang;YANG Bin. Evaluation of CT in the diagnosis of xanthogranulomatous cholecystitis[J]. Journal of China Clinic Medical Imaging. 2007, 18(2): 123-125

中图分类号： Ｒ575.61 Ｒ814.42