Choi B I, Lee J H, Han M C, Kim S H, Yi J G, Kim C W
Department of Radiology, College of Medicine, Seoul National University, Korea.
Radiology. 1989 Sep;172(3):689-92. doi: 10.1148/radiology.172.3.2549565.
Fifty-one patients were studied to determine the relative accuracy of sonography and computed tomography (CT) in the evaluation of hilar cholangiocarcinoma. Both sonography and CT permitted detection of intrahepatic bile duct dilatation in all patients. Nonunion of right and left intrahepatic bile ducts was identified with sonography in 90% and with CT in 94% of patients. The tumor per se was depicted by sonography in 21% and by CT in 40% of patients. Forty tumors (78%) were of the infiltrating type, seven (14%) were exophytic, and four (8%) were polypoid. With sonography, infiltrating and exophytic tumors were difficult to depict, whereas polypoid tumors were well identified. With CT, infiltrating tumors were more difficult to depict than were exophytic or polypoid tumors. On CT scans, depicted tumors of the infiltrating type showed high attenuation and an indistinct margin, whereas exophytic and polypoid tumors showed low attenuation and a well-defined margin. Sonography and CT were comparably accurate in determining the level of obstruction in hilar cholangiocarcinoma even when no mass was depicted. CT was superior to sonography in depicting tumor per se and in demonstrating associated findings.
对51例患者进行了研究，以确定超声检查和计算机断层扫描（CT）在肝门部胆管癌评估中的相对准确性。超声检查和CT均能在所有患者中检测到肝内胆管扩张。90%的患者通过超声检查、94%的患者通过CT检查发现左右肝内胆管不连通。21%的患者通过超声检查、40%的患者通过CT检查显示出肿瘤本身。40个肿瘤（78%）为浸润型，7个（14%）为外生型，4个（8%）为息肉样。超声检查时，浸润型和外生型肿瘤难以显示，而息肉样肿瘤则能清晰识别。CT检查时，浸润型肿瘤比外生型或息肉样肿瘤更难显示。在CT扫描中，显示的浸润型肿瘤表现为高密度且边界不清，而外生型和息肉样肿瘤表现为低密度且边界清晰。即使未显示肿块，超声检查和CT在确定肝门部胆管癌的梗阻水平方面准确性相当。CT在显示肿瘤本身及相关表现方面优于超声检查。
