黄色肉芽肿性胆囊炎的影像诊断分析
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摘要
目的:探讨黄色肉芽肿性胆囊炎(XGC)的CT及MR表现,以提高对XGC的影像表现的认识。方法:回顾性分析19例经手术病理证实的XGC影像学表现,分析其影像学特点。结果:所有病例均有不同程度的胆囊壁增厚,其中15例增厚胆囊壁内(15/19,78.9%)出现低密度结节或低密度带,9例(9/19,47.4%)出现胆囊黏膜不连续。此外,胆囊内结石12例(包括胆囊颈(管)结石5例),胆总管结石2例。结论:增厚胆囊壁内低密度结节或低密度带是XGC较具特征性的影像学表现,而胆囊内黏膜的连续或不连续均可以出现。
Purpose:To investigate CT and MR features of xanthogranulomatous cholecystitis(XGC), in order to improve the preoperative diagnosis of the disease. Methods:The imaging features of 19 cases with XGC confirmed by histopathology results were analyzed retrospectively. Results:In all 19 cases, the gallbladder walls were thickened with varying degrees. Among them, 15(78.9%, 15/19) cases were with intramural hypodense nodules and hypodense bands in the thickened wall. In 9(47.4%, 9/19) cases, gallbladder mucosa was discontinuous. In addition, there were12 cases with gallstones(including 5 cases in the neck and duct of gallbladder) and 2 cases with choledocholithiasis.Conclusion:Hypodensity nodules or bands in thickened gallbladder walls are characteristics of XGC. Meanwhile, the mucosal lining of gallbladder wall may be continuous or discontinuous in XGC.
Purpose:To investigate CT and MR features of xanthogranulomatous cholecystitis(XGC), in order to improve the preoperative diagnosis of the disease. Methods:The imaging features of 19 cases with XGC confirmed by histopathology results were analyzed retrospectively. Results:In all 19 cases, the gallbladder walls were thickened with varying degrees. Among them, 15(78.9%, 15/19) cases were with intramural hypodense nodules and hypodense bands in the thickened wall. In 9(47.4%, 9/19) cases, gallbladder mucosa was discontinuous. In addition, there were12 cases with gallstones(including 5 cases in the neck and duct of gallbladder) and 2 cases with choledocholithiasis.Conclusion:Hypodensity nodules or bands in thickened gallbladder walls are characteristics of XGC. Meanwhile, the mucosal lining of gallbladder wall may be continuous or discontinuous in XGC.
引文
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[6]Rammohan A,Cherukuri SD,Sathyanesan J,et al.Xanthogranulomatous cholecystitis masquerading as gallbladder cancer:Can it be diagnosed preoperatively?Gastroenterology Research and Practice,2014,2014:253645
[7]Kwon AH,Matsui Y,Uemura Y.Surgical procedures and histopathologic findings for patients with xanthogranulomatous cholecystitis.Journal of the American College of Surgeons,2004,199:204-210
[8]Zhao F,Lu PX,Yan SX et al.CT and MR features of xanthogranulomatous cholecystitis:an analysis of consecutive 49cases.European Journal of Radiology,2013,82:1391-1397
[9]宁尚峰,廖玲.黄色肉芽肿性胆囊炎的CT诊断.中国医学计算机成像杂志,2008,14:39-42
[10]Jain S,Saluja S S,Sharma A K,et al.Xanthogranulomatous cholecystitis:catching the culprit-clinical and imaging analysis.Digestive Surgery,2012,29:187-193.
[11]Lee ES,Kim JH,Joo I,et al.Xanthogranulomatous cholecystitis:diagnostic performance of US,CT,and MRI for differentiation from gallbladder carcinoma.Abdominal Imaging,2015,40:2281-2292
[12]Wasnik AP,Davenport MS,Kaza RK,et al.Diagnostic accuracy of MDCT in differentiating gallbladder cancer from acute and xanthogranulomatous cholecystitis.Clinical Imaging,2018,50:223-228.
[13]Binit S,Vaibhav P S,S.Rajesh R,et al.Computed tomography(CT)and magnetic resonance(MR)findings in xanthogranulomatous cholecystitis.retrospective analysis of pathologically proven 30 cases-tertiary care experience.Polish Journal of Radiology,2017,82:327-332
[14]Hsu C,Hurwitz J L,Schuss A,et al.Radiology-pathology conference:xanthogranulomatous cholecystitis.Clinical Imaging,2003,27:421-425.
[2]Yucel O,Uzun MA,Tilki M,et al.Xanthogranulomatous Cholecystitis:Analysis of 108 Patients.The Indian Journal of Surgery,2017,79:510-514.
[3]Singh VP,Rajesh S,Bihari C,et al.Xanthogranulomatous cholecystitis:what every radiologist should know.World Journal of Radiology,2016,8:183-191
[4]Ishii T,Hatano E,Yasuchika K,et al.A case of xanthogranulomatous cholecystitis suspected to be adenocarcinoma based on the intraoperative peritoneal washing cytology.International Journal of Surgery Case Reports,2014,5:138-141
[5]Jetley S,Rana S,Khan R N,et al.Xanthogranulomatous cholecystitis-a diagnostic challenge.Journal of the Indian Medical Association,2012,110:833-837.
[6]Rammohan A,Cherukuri SD,Sathyanesan J,et al.Xanthogranulomatous cholecystitis masquerading as gallbladder cancer:Can it be diagnosed preoperatively?Gastroenterology Research and Practice,2014,2014:253645
[7]Kwon AH,Matsui Y,Uemura Y.Surgical procedures and histopathologic findings for patients with xanthogranulomatous cholecystitis.Journal of the American College of Surgeons,2004,199:204-210
[8]Zhao F,Lu PX,Yan SX et al.CT and MR features of xanthogranulomatous cholecystitis:an analysis of consecutive 49cases.European Journal of Radiology,2013,82:1391-1397
[9]宁尚峰,廖玲.黄色肉芽肿性胆囊炎的CT诊断.中国医学计算机成像杂志,2008,14:39-42
[10]Jain S,Saluja S S,Sharma A K,et al.Xanthogranulomatous cholecystitis:catching the culprit-clinical and imaging analysis.Digestive Surgery,2012,29:187-193.
[11]Lee ES,Kim JH,Joo I,et al.Xanthogranulomatous cholecystitis:diagnostic performance of US,CT,and MRI for differentiation from gallbladder carcinoma.Abdominal Imaging,2015,40:2281-2292
[12]Wasnik AP,Davenport MS,Kaza RK,et al.Diagnostic accuracy of MDCT in differentiating gallbladder cancer from acute and xanthogranulomatous cholecystitis.Clinical Imaging,2018,50:223-228.
[13]Binit S,Vaibhav P S,S.Rajesh R,et al.Computed tomography(CT)and magnetic resonance(MR)findings in xanthogranulomatous cholecystitis.retrospective analysis of pathologically proven 30 cases-tertiary care experience.Polish Journal of Radiology,2017,82:327-332
[14]Hsu C,Hurwitz J L,Schuss A,et al.Radiology-pathology conference:xanthogranulomatous cholecystitis.Clinical Imaging,2003,27:421-425.