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患者女性,64岁。无明显诱因出现右上腹间断疼痛4天,加重1天,疼痛向肩背部放射,可自行缓解。查体:上腹部轻度压痛,Murphy征(+)。MRI示胆囊左侧壁见长径4.2 cm分叶状软组织结节,边缘呈渐进性强化,中央坏死区无强化,与邻近肝组织分界不清,内见3.6 cm下环形强化灶,胆囊底部另见数个结节影堆积。考虑胆囊癌侵及邻近肝实质,胆囊结石。彩色多普勒超声示胆囊颈部实性团块,胆
Patient female, 64 years old. There is no obvious incentive to appear intermittent right upper quadrant pain for 4 days, aggravating one day, the pain radiates to the back of the shoulder, relieve itself. Examination: mild tenderness in the abdomen, Murphy sign (+). MRI showed that the left side of the gallbladder showed long 4.2 mm lobular soft tissue nodules with progressive enhancement of the margin, no enhancement of the central necrotic area, unclear borders with adjacent liver tissue, an annular enhancement at 3.6 cm, and a cystic bottom at the gallbladder Several nodules accumulate. Consider the invasion of gallbladder cancer and adjacent liver parenchyma, gallstone. Color Doppler ultrasound showed gallbladder neck solid mass, gallbladder