Kalra Naveen, Gupta Pankaj, Singhal Manphool, Gupta Rajesh, Gupta Vikas, Srinivasan Radhika, Mittal Bhagwant R, Dhiman Radha K, Khandelwal Niranjan
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India.
Department of General Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India.
J Clin Exp Hepatol. 2019 May-Jun;9(3):334-344. doi: 10.1016/j.jceh.2018.04.005. Epub 2018 Apr 30.
Gallbladder Carcinoma (GBCA) is the most common biliary tract malignancy. As the disease is often diagnosed clinically in an advanced stage, the survival rates are dismal. Imaging studies allow for an early diagnosis of malignancy, though the findings may be indistinguishable from non-malignant disease processes affecting the gallbladder. Attempts have been made to make a specific diagnosis of GBCA at an early stage on imaging studies. Ultrasonography (US) is the most commonly employed technique for gallbladder evaluation. Gallbladder wall thickening is the most common finding of early GBCA and in this context, US is non-specific. Recently, contrast enhanced ultrasound has been shown to be effective in differentiating benign from malignant disease. Multidetector computed tomography represents the most robust imaging technique in evaluation of GBCA. It provides relatively sensitive evaluation of mural thickening, though it is not entirely specific and issues in differentiating GBCA from xanthogranulomatous cholecystitis do arise. Due to its superior soft tissue resolution, Magnetic Resonance Imaging (MRI) provides excellent delineation of gallbladder and biliary tree involvement. When coupled with functional MRI techniques, such as diffusion-weighted and perfusion imaging, it provides a useful problem solving tool for interrogating the malignant potential of nonspecific gallbladder lesions and detection of metastases. Positron emission tomography has a role in detection of distant metastases and following patients following treatment for malignancy. We review the current role of various imaging modalities in evaluating patients with GBCA.
胆囊癌（GBCA）是最常见的胆道恶性肿瘤。由于该疾病在临床上往往在晚期才被诊断出来，生存率很低。影像学检查有助于早期诊断恶性肿瘤，不过其结果可能与影响胆囊的非恶性疾病过程难以区分。人们一直在尝试在影像学检查中对早期胆囊癌进行特异性诊断。超声检查（US）是评估胆囊最常用的技术。胆囊壁增厚是早期胆囊癌最常见的表现，在这种情况下，超声检查并无特异性。最近，已证明超声造影在区分良性和恶性疾病方面是有效的。多排螺旋计算机断层扫描是评估胆囊癌最可靠的成像技术。它对胆囊壁增厚的评估相对敏感，尽管并不完全具有特异性，而且在区分胆囊癌和黄色肉芽肿性胆囊炎时确实会出现问题。由于其卓越的软组织分辨率，磁共振成像（MRI）能很好地描绘胆囊和胆道系统的受累情况。当与功能磁共振成像技术，如扩散加权成像和灌注成像相结合时，它为探究非特异性胆囊病变的恶性潜能和检测转移灶提供了一个有用的问题解决工具。正电子发射断层扫描在检测远处转移以及对恶性肿瘤患者进行治疗后随访方面发挥着作用。我们综述了各种成像方式在评估胆囊癌患者中的当前作用。
