黄色肉芽肿性胆囊炎的MRI特点分析
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摘要
目的分析黄色肉芽肿性胆囊炎(XGC)的MRI影像学特点。方法回顾性分析13例经病理学确诊XGC的MRI表现。结果 13例XGC的胆囊壁不同程度增厚,厚度3～10 mm的8例,≥10 mm的5例。胆囊壁弥漫型增厚12例,局灶型增厚1例。胆囊壁信号不均匀13例。胆囊结石13例,胆总管结石3例,胆管扩张3例。周围小淋巴结3例。周围脂肪间隙模糊8例,浸润十二指肠球部1例。增强扫描4例,均表现为胆囊壁不均匀强化,黏膜呈线样连续强化,浸润邻近肝实质。结论 MRI能显示XGC的较多特点,特别是增强MRI对于术前诊断XGC有较高价值。
Objective To analyze the MRI features of xanthogranulomatous cholecystitis(XGC). Methods A retrospective analysis was made on MRI findings for 13 cases of pathologically confirmed XGC. Results The gallbladder wall of the 13 XGC cases were thickened in varying degrees, 8 cases with thickness of 3～10 mm and 5 cases with thickness of more than 10 mm. Diffuse thickening of gallbladder wall occupied in 12 cases and focal thickening in 1 case. All the 13 cases reflected gallbladder wall signal unevenness. Cholecystolithiasis was found in 13 cases, bile duct stones in 3 cases and bile duct dilatation in 3 cases. Peripheral small lymph nodes were reported in 3 cases. Peripheral adipose space was blurred in 8 cases and infiltrated into duodenal bulb in 1 case. Four cases underwent enhanced scan, all of which showed uneven enhancement of gallbladder wall, continuous enhancement of mucosa and infiltration into adjacent liver parenchyma. Conclusion MRI can show many features of XGC, especially enhanced MRI has high value for preoperative diagnosis of XGC.
Objective To analyze the MRI features of xanthogranulomatous cholecystitis(XGC). Methods A retrospective analysis was made on MRI findings for 13 cases of pathologically confirmed XGC. Results The gallbladder wall of the 13 XGC cases were thickened in varying degrees, 8 cases with thickness of 3～10 mm and 5 cases with thickness of more than 10 mm. Diffuse thickening of gallbladder wall occupied in 12 cases and focal thickening in 1 case. All the 13 cases reflected gallbladder wall signal unevenness. Cholecystolithiasis was found in 13 cases, bile duct stones in 3 cases and bile duct dilatation in 3 cases. Peripheral small lymph nodes were reported in 3 cases. Peripheral adipose space was blurred in 8 cases and infiltrated into duodenal bulb in 1 case. Four cases underwent enhanced scan, all of which showed uneven enhancement of gallbladder wall, continuous enhancement of mucosa and infiltration into adjacent liver parenchyma. Conclusion MRI can show many features of XGC, especially enhanced MRI has high value for preoperative diagnosis of XGC.
引文
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[7]Uchiyama K,Ozawa S,Ueno M,et al.Xanthogranulomatous cholecystitis:the use of preoperative CT findings to differentiate it from gallbladder carcinoma[J].J Hepatobiliary Pancreat Surg,2009,16(3):333-338.
[8]张亚,郑玉丽,范国光.黄色肉芽肿性胆囊炎的影像学诊断(附5例报告)[J].医学影像学杂志,2017,27(9):1734-1737.
[9]邱智泉,于勇,罗祥基,等.胆囊癌与黄色肉芽肿性胆囊炎的鉴别诊断及手术治疗策略[J].中华肝胆外科杂志,2017,23(5):336-338.
[10]王强,陈雀芦,胡文超,等.胆囊腺肌瘤病的CT与MRI诊断价值[J].肝胆胰外科杂志,2015,27(4):299-302.
[2]王蔚蓝,孙海明.黄色肉芽肿性胆囊炎45例诊治分析[J].肝胆胰外科杂志,2015,27(1):74-75.
[3]Singh,Rajesh,Chhagan,et al.Xanthogranulomatous cholecystitis:What every radiologist should know[J].World J Radiol,2016,8(2):183-191.
[4]Goshima S,Chang S,Wang J H,et al.Xanthogranulomatous cholecystitis:diagnostic performance of CT to differentiate from gallbladder cancer[J].Eur J Radiol,2010,74(3):79-83.
[5]Ogawa T.High b-value diffusion-weighted magnetic resonance imaging for gallbladder lesions:differentiation between benignity and malignancy[J].J Gastroenterol,2012,47(12):1352-1360.
[6]马光慧,嵇鸣,叶春涛,等.黄色肉芽肿性胆囊炎的MRI特征[J].磁共振成像,2014(4):283-286.
[7]Uchiyama K,Ozawa S,Ueno M,et al.Xanthogranulomatous cholecystitis:the use of preoperative CT findings to differentiate it from gallbladder carcinoma[J].J Hepatobiliary Pancreat Surg,2009,16(3):333-338.
[8]张亚,郑玉丽,范国光.黄色肉芽肿性胆囊炎的影像学诊断(附5例报告)[J].医学影像学杂志,2017,27(9):1734-1737.
[9]邱智泉,于勇,罗祥基,等.胆囊癌与黄色肉芽肿性胆囊炎的鉴别诊断及手术治疗策略[J].中华肝胆外科杂志,2017,23(5):336-338.
[10]王强,陈雀芦,胡文超,等.胆囊腺肌瘤病的CT与MRI诊断价值[J].肝胆胰外科杂志,2015,27(4):299-302.