CAJ | 학술논문

目的：探讨肝内胆管细胞癌的CT影像误诊原因，提高其诊断准确率。方法回顾性分析病理确诊为肝内胆管细胞癌且CT误诊的17例患者的影像资料，观察病变位置、形态、强化方式及伴随征象并联合临床表现及实验室检查结果进行分析。结果9例误诊为肝细胞癌，3例误诊为胆总管囊肿或结石伴胆管扩张，3例误诊为肝脓肿，1例误诊为肝血管瘤，1例误诊为肝转移瘤。导致误诊的原因主要有：未做延迟扫描致病灶强化方式及特点不明确、影像诊断医师观察不仔细致遗漏一些关键影像表现、合并其他肝脏基础疾病致影像表现复杂等。结论肝内胆管细胞癌CT诊断误诊率较高，但其CT表现仍具有一定的特征性。
목적：탐토간내담관세포암적CT영상오진원인，제고기진단준학솔。방법회고성분석병리학진위간내담관세포암차CT오진적17례환자적영상자료，관찰병변위치、형태、강화방식급반수정상병연합림상표현급실험실검사결과진행분석。결과9례오진위간세포암，3례오진위담총관낭종혹결석반담관확장，3례오진위간농종，1례오진위간혈관류，1례오진위간전이류。도치오진적원인주요유：미주연지소묘치병조강화방식급특점불명학、영상진단의사관찰불자세치유루일사관건영상표현、합병기타간장기출질병치영상표현복잡등。결론간내담관세포암CT진단오진솔교고，단기CT표현잉구유일정적특정성。
Objective To investigate the reason of the misdiagnosis in the CT imaging of intrahepatic chol-angiocarcinoma to improve the diagnostic accuracy. Methods Seventeen patients diagnozed as intrahepatic cholan-giocarcinoma by pathology and misdiagnosed by CT were retrospectively analyzed. The location, shape, strengthening manner and accompanied signs of lesion and joint clinical manifestations and laboratory test results were analyzed. Results Nine patients were misdiagnosed as hepatocellular carcinoma, and 3 were misdiagnosed as choledochal cyst or stone and bile duct dilation, with 3 as liver abscess, 1 as liver blood vessels aneurysm, and 1 as liver metastases. The main causes of misdiagnosis were as follows:unclear lesion enhancement and characters due to not performing delayed scan, negligence of radiologists, and complex imaging manifestations due to complication with other underly-ing diseases of liver. Conclusion The misdiagnosis rate of intrahepatic cholangiocarcinoma by CT is high, but the CT imaging performance still has certain characteristics.