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目的比较周围型肝内胆管细胞癌(PIHCC)的CT和超声双期增强的特点,探讨两种方法诊断PIHCC的价值。方法回顾性分析经手术及病理证实的20例PIHCC的CT和超声双期(动脉期和门静脉期)增强的资料。CT动脉期、门静脉期扫描时间分别为注入对比剂后25 s、60 s,超声造影分别为9～40 s、41～120 s。结果肿瘤最大径3.0～16.0 cm,位于肝左叶9例,肝右叶11例。CT双期全瘤低增强8例中超声造影7例(87.5%)表现为全瘤的低增强;CT双期环形增强12例中超声造影10例(83.3%)表现为周边环形增强。超声造影门静脉期瘤内低增强范围较动脉期扩大12例(60%)。PIHCC的CT双期增强方式与超声造影比较无统计学差异(x~2=1.33,P>0.05)。动脉期瘤内小血管CT显示4例(20%),超声造影显示10例(50%),两者比较有显著性差异(x~2=4.17,P<0.05)。结论PIHCC的CT和超声双期增强方式相似,两者均能为诊断PIHCC提供重要信息。超声双期增强显示瘤内小血管优于CT。
Objective To compare the characteristics of double-phase CT and ultrasound enhancement of peripheral intrahepatic cholangiocarcinoma (PIHCC) and to explore the value of the two methods in the diagnosis of PIHCC. Methods The data of 20 cases of PIHCC confirmed by operation and pathology were retrospectively analyzed with double enhancement of CT and ultrasound (arterial phase and portal vein phase). CT arterial phase and portal venous phase scan time were 25 s and 60 s respectively after injection of contrast agent, and the echocardiography was 9 ~ 40 s and 41 ~ 120 s respectively. Results The maximum diameter of tumor was 3.0 ~ 16.0 cm, located in 9 cases of left lobe of liver and 11 cases of right lobe of liver. Seven cases (87.5%) underwent contrast-enhanced ultrasonography in 8 cases of CT double-phase low-contrast enhancement showed low enhancement of whole-neoplasm; 10 cases (83.3%) of 12 cases underwent CT double-ring enhancement enhanced peripheral enhancement. Contrast-enhanced ultrasonography in the portal venous phase expanded 12 (60%) compared with the arterial phase. There was no significant difference in CT double-phase enhancement mode between PIHCC and CEUS (x ~ 2 = 1.33, P> 0.05). Small artery CT showed 4 cases (20%) in arterial phase and 10 cases (50%) by contrast - enhanced ultrasound. There was significant difference between the two groups (x ~ 2 = 4.17, P <0.05). Conclusions Both CT and ultrasound enhancement of PIHCC are similar, and both of them can provide important information for the diagnosis of PIHCC. Two-phase ultrasound showed that small vessels in the tumor were superior to CT.