肝內膽管腺癌的磁振影像

MRI of Intrahepatic Cholangiocarcinoma

吳秀美(Hsiu-Mei Wu) ； 鄭慧正(Hui-Cheng Cheng) ； 曾修山(Hsiuo-Shan Tseng) ； 黃振義(Jen.I. Hwang) ； 姜仁惠(Jen-Huey Chiang) ； 蘇正熙(Cheng-Hsi Su) ； 石宜銘(Yi-Ming Shyr) ； 張政彥(Chen-Yen Chang)

《中華放射線醫學雜誌》 20卷4期 (1995/12) Pp. 345-354

摘要

磁振影像有優異的組織訊號對比，已知對多種肝臟腫瘤有很好的評估，但有關膽管腺癌的報告不多。本研究收集了20例肝內膽管腺癌的磁振影像，分別評估磁振影像對腫瘤的偵測力，腫瘤在各個脈衝程序上的表現，以及比較各脈衝程序的優劣點。周邊型膽管腺癌以腫塊或多結節型較多，訊號隨纖維組織含量不同而不同，多數在T2WI上呈現周邊高訊而中央低訊，注射顯影劑後呈現持久之周邊顯影。肝門型膽管腺細胞癌以浸潤硬結型較多，在磁振影像上為沿著膽管浸潤，界線不明，訊號均勻的組織，T1WI低訊，T2WI中等訊，均勻顯影。傳統磁振影像對於肝內膽管腺癌有很好的偵測和評估力，尤其是顯影後影像。而顯影劑動力學檢查，除了可以增加腫瘤與肝臟訊號的差異而增加診斷者的信心外，還可以提供血流動力的資料以供鑑別診斷，以及加強對血管的評估和對肝內、外轉移的偵測力。

關鍵字

膽道，磁振造影 ； 膽道，腫瘤 ； 肝腫瘤，磁振造影像

並列摘要

With the development of newer techniques, magnetic resonance image (MRI) of the liver has become even more effective. With its good tissue contrast, lesion detection and differential diagnosis are improved. However, there have been few reports concerning use of MRI with intrahepatic cholangiocarcinoma. This article retrospectively reviewed the MRI findings of 20 intrahepatic cholangiocarcinomas seen in this hospital. Common findings in the peripheral-type intrahepatic cholangiocarcinomas were either a single mass or a conflunence of multiple nodules. These showed as low signal intensity on T1WI, heterogenous medium high signal intensity on T2WI with some central low signal intensity; most also showed some periductal infiltration. The administration of Gd-DTPA usually demonstrated progressive centropedal enhancement on dynamic study, and prolonged peripheral enhancement on post-contrast image. A majority of the hilar-type intrahepatic cholangiocarcinomas were infiltrative in nature, presenting periductal low signals on T1WI, medium signals on T2WI and homogenous enhancement on post contrast image. There was a high tumor visualization rate (100%) on conventional MRI. Gd-DTPA has shown to be valuable for characterization and delineation of both types of intra-hepatic cholangiocarcinoma. Dynamic contrast study provided good images of portal veins. A high incidence of portal vein encasement in peripheral and hilar types (90%) was noted in this study.

並列關鍵字

Bile ducts, MR ； Bile ducts, neoplasms ； Liver neoplasms, MR