Karstrup S
Department of Diagnostic Ultrasound, University Hospital, Herlev, Denmark.
Br J Radiol. 1988 Nov;61(731):987-90. doi: 10.1259/0007-1285-61-731-987.
The findings on ultrasound of 31 consecutive patients with pathologically proven Klatskin tumours are reviewed. In all patients, ultrasound disclosed dilated intrahepatic bile radicles and normal common bile ducts. A well defined, rounded, solid tumour mass was detected in 11 (35%) patients. Compared with the findings at surgery or autopsy, ultrasound disclosed eight of 12 tumours presenting as extraductal masses. In 16 patients with tumour growth predominantly along the bile ducts, ultrasound disclosed poorly demarcated echogenic tissue high in the hepatic hilum in four cases. In only two patients was it possible to detect tumour spread. Ultrasound-guided, fine-needle aspiration biopsy was performed in seven patients revealing malignant cells in five cases and fine-needle tissue biopsy was performed in two cases revealing malignant tissue. The presence of intrahepatic dilated bile radicles with normal-sized common bile ducts should raise the possibility of a high bile duct carcinoma. If a tumour lesion is detected we suggest the use of ultrasound-guided, fine-needle biopsy.
回顾了31例经病理证实为肝门部胆管癌患者的超声检查结果。所有患者超声均显示肝内胆管分支扩张而胆总管正常。11例（35%）患者检测到边界清晰、圆形的实性肿瘤肿块。与手术或尸检结果相比，超声检出12例表现为胆管外肿块的肿瘤中的8例。16例肿瘤主要沿胆管生长的患者中，超声在4例患者肝门处发现边界不清的高回声组织。仅2例患者检测到肿瘤扩散。7例患者进行了超声引导下细针穿刺活检，5例发现恶性细胞，2例进行了细针组织活检，发现恶性组织。肝内胆管分支扩张而胆总管大小正常时，应考虑高位胆管癌的可能性。如果检测到肿瘤病变，我们建议采用超声引导下细针活检。
