電腦斷層攝影診斷膽囊癌

Computed Tomography Diagnosis of Gallbladder Carcinoma

王至俊(J. J. Wang) ； 刁翠美(C. M. Tiu) ； 周宜宏(Y. H. Chou) ； 姜仁惠(J. H. Chiang) ； 王家槐(J. H. Wang) ； 楊建芳(C. F. Yang) ； 張遵(T. Chang)

《中華放射線醫學雜誌》 10卷2期 (1985/06) Pp. 101-107

摘要

膽囊癌在消化系統器官癌中，算是少見的疾病，過去傳統的放射線學檢查，對此病的診斷不易，故其術前的診斷率偏低。近年來醫用超音波與電腦斷層攝影的使用，使膽囊癌的診斷率大為提高。榮民總醫院從69年12月至73年3月，三年多來經病理證實而做過電腦斷層檢查的17個病例加以討論。此17個病例中，除3例為女性外，餘均為男性，年齡除一位為20歲外，餘為54歲至77歲間，平均年齡為60.9歲。依其表徵分四種型，typeⅠ：腫瘤型4例(25%)，typeⅡ：侵潤型3例(18.8%)，typeⅢ：息肉型6例(37.5%)，typeⅣ：侵潤合併腫瘤型3例(18.8%)，餘一例不能區分。合併有膽結石者5例(31.2%)，膽管擴張6例(37.5%)，肝轉移7例(44%)，肝門淋巴結腫大1例(6.3%)；本文就各種型的膽囊癌加以分析討論之。

並列摘要

Gallbladder carcinoma is not common in the tumor of the gastrointestinal system. Conventional radiographic examination was not helpful and the pre-operative diagnosis is minute before the application of ultrasound and computed tomography in the medical field. We have collected 17 proved cases of gallbladder carcinoma in the recent three years, starting from December 1980 to March 1984 which we came across in the Veterans General Hospital. There are only three female patients and the age group ranged from 20 to 77 years with a mean age of 60.9. The CT scan appearance could be classified into four types which have been mentioned by other authors. There are four cases in type Ⅰ which consist of soft tissue mass in the gallbladder; three cases of type Ⅱ which consist of thickening of the gallbladder wall, indicating presence of infiltration of malignant cells; six cases of type Ⅲ which show the presence of a fungating mass inside the gallbladder lumen and finally three cases of type Ⅳ which is a combination of type. Ⅰand type Ⅲ. There are also other findings including liver metastasis (7 cases), biliary dilatation (6 cases) and localized lymph node enlargement (1 case).