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目的 :通过对22例胆囊癌CT表现分析 ,探讨胆囊癌CT诊断价值和鉴别诊断 ,提高胆囊癌CT诊断水平。材料与方法 :本文收集经病理证实的22例胆囊癌病例 ,均做CT检查 ,其中10例行B超检查。分析其CT表现。结果 :胆囊癌女性多见 ,男女之比为1∶2.1 ,好发于50岁以上患者。临床表现为上腹痛并肩背痛、黄疸及腹部肿块。CT表现 :①胆囊区肿块 ,密度不均 ,胆囊腔缩小或消失 ;②胆囊壁增厚 ,呈局限或弥漫性不规则增厚 ;③胆囊腔内软组织块影 ;④合并胆结石 ;⑤肝内外胆管扩张 ;⑥肝脏直接受侵犯 ;⑦累及胰和十二指肠 ;⑧肝脏转移 ,侵犯腹壁 ,合并腹水。结论 :胆囊癌并发结石 ,低于国外报道 ,与国内文献报道相近。CT诊断正确率略高于B超检查。CT对胆囊癌的诊断价值 :①CT对软组织分辨率高 ,可较清晰显示胆囊的原发病变和肿瘤扩散范围 ;②造影增强扫描可显示胆囊壁真正的厚度 ,而肿瘤所致增厚的胆囊壁密度高于正常胆囊壁及肝脏。本组1例早癌具有该征象 ,认为该征象极有利于胆囊癌的早期诊断。胆囊癌需与慢性胆囊炎、胆囊息肉及肝癌相鉴别。
Objective : To analyze the CT features of gallbladder carcinoma in 22 cases, to investigate the diagnostic value and differential diagnosis of gallbladder carcinoma and to improve the CT diagnosis of gallbladder carcinoma. Materials and Methods: This article collected 22 pathologically confirmed cases of gallbladder cancer, CT examinations were performed, of which 10 cases were B-ultrasound. Analyze its CT performance. RESULTS: Gallbladder cancer was more common in females, with a ratio of 1:2.1 for males and females and occurred in patients over 50 years of age. The clinical manifestations of upper abdominal pain and shoulder and back pain, jaundice and abdominal mass. CT manifestations: 1 gallbladder mass, uneven density, gallbladder cavity shrinkage or disappearance; 2 gallbladder wall thickening, showed irregular or diffuse thickening; 3 gallbladder cavity soft tissue block shadow; 4 gallstones; 5 liver and outside Bile duct dilatation; 6 liver directly affected; 7 involving the pancreas and duodenum; 8 liver metastasis, invading the abdominal wall, accompanied by ascites. Conclusion: The gallstones complicated by gallstones are lower than those reported abroad, and are similar to those reported in domestic literature. The diagnostic accuracy of CT is slightly higher than that of B-ultrasound. The diagnostic value of CT on gallbladder cancer: 1 CT has high resolution of soft tissue, can clearly show the primary lesions of the gallbladder and the scope of tumor proliferation; 2 contrast enhanced scan can show the true thickness of the gallbladder wall, and the thickened gallbladder wall caused by the tumor Density is higher than normal gallbladder wall and liver. This group of 1 case of early cancer has this sign that the sign is very conducive to the early diagnosis of gallbladder cancer. Gallbladder cancer needs to be differentiated from chronic cholecystitis, gallbladder polyps and liver cancer.