CAJ | 학술논문

目的：探讨胆总管腺瘤的C T及M RI特征表现，增加对胆总管腺瘤的认识，提高诊断准确率。方法回顾性分析经手术和病理证实的17例胆总管腺瘤的C T及M RI资料，所有患者均行C T平扫与增强扫描，10例同时行M RI平扫与增强扫描。结果17例中9例为绒毛管状腺瘤，5例为绒毛状腺瘤，3例为管状腺瘤；其中5例位于胆总管上段，9例位于胆总管下段，3例范围弥漫；17例病灶中14例为局限性软组织影，呈偏心性膨胀性生长或局部呈胆管内铸型改变，3例为弥漫片絮状影。病变CT平扫均为等密度，增强扫描15例中度强化，2例轻度强化；MRI病例 T1WI为等或略低信号，T2 WI呈高信号7例、等信号3例，DWI（b＝600）均为高信号；17例中12例病灶呈不规则形，5例呈类圆形。17例均伴有胆总管扩张，且相应的胆管壁未见明显局限性增厚，5例伴有结石者，结石均位于病变上部。结论胆总管腺瘤具有一定的影像学特征，掌握这些CT及MR表现有助于提高诊断的准确性。
목적：탐토담총관선류적C T급M RI특정표현，증가대담총관선류적인식，제고진단준학솔。방법회고성분석경수술화병리증실적17례담총관선류적C T급M RI자료，소유환자균행C T평소여증강소묘，10례동시행M RI평소여증강소묘。결과17례중9례위융모관상선류，5례위융모상선류，3례위관상선류；기중5례위우담총관상단，9례위우담총관하단，3례범위미만；17례병조중14례위국한성연조직영，정편심성팽창성생장혹국부정담관내주형개변，3례위미만편서상영。병변CT평소균위등밀도，증강소묘15례중도강화，2례경도강화；MRI병례 T1WI위등혹략저신호，T2 WI정고신호7례、등신호3례，DWI（b＝600）균위고신호；17례중12례병조정불규칙형，5례정류원형。17례균반유담총관확장，차상응적담관벽미견명현국한성증후，5례반유결석자，결석균위우병변상부。결론담총관선류구유일정적영상학특정，장악저사CT급MR표현유조우제고진단적준학성。
Objective To explore CT and MRI fingdings of common bile duct adenoma in order to increase the under‐standing of common bile duct adenoma and to improve its diagnostic accuracy .Methods Clinical data and findings of CT and MRI in 17 patients with pathologically confirmed common bile duct adenoma were reviewed retrospectively .Abdominal no‐enhanced and enhanced CT scans were berformed in all cases ,and 10 of whom underw‐ent no‐enhanced and enhanced MRI .Results 9 of the 17 cases were tubular villous adenoma histopathologically ,5 villous adenoma and 3 tubular adeno‐ma .5 cases located in the upper section of common bile duct ,and 9 cases located in hypomere common bile duct ,in addi‐tion ,3 cases located in the wide range of extrahepatic biliary .14 cases of all displayed the limitations of soft tissue shadow and showed partial decentered expansion growth or local mold change in the bile duct ,however ,3 case were diffusety floc‐culent shadow .All lesions on CT scan were isodensity ,and 15 cases were moderate reinforcement on enhanced CT scan , only 2 cases were slight reinforcement .Cases of MRI were isointensity or slightly low signal intensity on T1WI ,and high signal intensity appearea in 7 cases ,isointensity in 3 cases on T2 WI .All lesions were demonstrated with a hyperintense on DWI (b=600) .12 lesions were presented with an irregular margin ,and 5 with nearly round margin .Bile duct dilatation was found in all cases ,and corresponding partly thickening bile duct wall were not found .5 cases were accompanied by bile duct stones that were located in the upside of the lesions .Conclusion Common bile duct adenoma has certain imaging characteristics ,and to master the CT and MRI fundings is helpful to improve the accuracy of diagnosis .