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目的探讨MRI诊断黄色肉芽肿性胆囊炎(XGC)的临床价值,同时分析其影像学表现的病理学基础。方法回顾性分析2013年1月至2015年11月期间在四川省人民医院行上腹部MRI检查且经术后病理学检查证实为XGC的7例患者的MRI图像资料。所有患者均接受了完整的MRI序列检查。每例患者重点观察胆囊壁增厚及强化情况、胆囊壁内结节、胆囊黏膜线是否完整、胆囊结石、胆囊周围组织改变等情况。结果 7例XGC患者的胆囊壁均增厚,其中2例呈局限性增厚,5例呈弥漫性增厚;4例见典型的“夹心饼干征”;6例胆囊黏膜线连续,1例不连续;5例胆囊壁内见结节影,在T1WI图像上呈低信号,在T2WI图像上呈高信号;6例并发胆囊结石;7例见胆囊周围脂肪间隙模糊、肝实质与胆囊分界不清;增强扫描时所有病例均出现动脉期胆囊周围肝实质斑片状一过性强化,1例并发肝脓肿;2例肝门部胆管狭窄、肝内胆管扩张,2例(1例伴有胆总管下端结石)肝内外胆管均轻度扩张;3例伴发肝囊肿,4例见单或双肾囊肿;7例均未发现腹腔内及腹膜后肿大淋巴结。结论 MRI检查可以准确描述XGC的各种影像学特征,对XGC的诊断具有重要价值。
Objective To investigate the clinical value of MRI in diagnosis of granulomatous yellow cholecystitis (XGC) and to analyze the pathological basis of its imaging findings. Methods The MRI data of 7 patients with upper abdomen MRI in Sichuan Provincial People’s Hospital from January 2013 to November 2015 were retrospectively analyzed and confirmed as XGC by pathological examination. All patients underwent a complete MRI sequence examination. Each patient focused on observation of gallbladder wall thickening and enhancement, gallbladder wall nodules, gallbladder mucosal line is complete, gallstones, gallbladder tissue changes around the situation. Results The gallbladder wall of 7 patients with XGC were thickened, of which 2 were localized thickening, 5 were diffuse thickening, 4 were typical “sandwich crackers”, 6 were continuous gallbladder mucosal line, 1 5 cases of gallbladder wall see nodules, showed low signal on the T1WI images, T2WI images showed high signal; 6 cases of gallbladder stones; 7 cases see the gap around the gallbladder fat gap, liver parenchyma and gallbladder demarcation Unclear; enhanced scanning in all cases occurred during arterial gallbladder parenchyma patchy transient enhancement in 1 case of liver abscess; 2 cases of hilar bile duct stricture, intrahepatic bile duct dilatation, 2 cases (1 with The lower common bile duct stones) were mild dilatation of the extrahepatic bile duct; 3 cases associated with liver cysts, 4 cases of single or double renal cysts; 7 cases did not find intraperitoneal and retroperitoneal lymph nodes. Conclusion MRI can accurately describe various imaging features of XGC and is of great value in the diagnosis of XGC.