Lopes Vendrami Camila, Magnetta Michael J, Mittal Pardeep K, Moreno Courtney C, Miller Frank H
From the Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 N St Clair St, Suite 800, Chicago, IL 60611 (C.L.V., M.J.M., F.H.M.); Department of Radiology, Medical College of Georgia, Augusta, Ga (P.K.M.); and Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (C.C.M.).
Radiographics. 2021 Jan-Feb;41(1):78-95. doi: 10.1148/rg.2021200087. Epub 2020 Dec 11.
Gallbladder carcinoma is the most common cancer of the biliary system. It is challenging to diagnose because patients are often asymptomatic or present with nonspecific symptoms that mimic common benign diseases. Surgical excision is the only curative therapy and is best accomplished at early non-locally advanced stages. Unfortunately, gallbladder cancer often manifests at late locally advanced stages, precluding cure. Early tumors are often incidentally detected at imaging or at cholecystectomy performed for another indication. Typical imaging features of localized disease include asymmetric gallbladder wall thickening, polyps larger than 1.0 cm, and a solid mass replacing the gallbladder lumen. Advanced tumors are often infiltrative and can be confusing at CT and MRI owing to their large size. Determination of the origin of the lesion is paramount to narrow the differential diagnosis but is often challenging. It is important to identify gallbladder cancer and distinguish it from other benign and malignant hepatobiliary processes. Since surgical resection is the only curative treatment option, radiologist understanding and interpretation of pathways of nodal and infiltrative tumor spread can direct surgery or preclude patients who may not benefit from surgery. While both CT and MRI are effective, MRI provides superior soft-tissue characterization of the gallbladder and biliary tree and is a useful imaging tool for diagnosis, staging, and evaluation of treatment response. RSNA, 2020.
胆囊癌是胆道系统最常见的癌症。其诊断具有挑战性，因为患者通常无症状或表现出类似常见良性疾病的非特异性症状。手术切除是唯一的治愈性疗法，在早期非局部晚期阶段进行效果最佳。不幸的是，胆囊癌常表现为局部晚期，无法治愈。早期肿瘤常在影像学检查或因其他指征进行胆囊切除术时偶然发现。局限性疾病的典型影像学特征包括胆囊壁不对称增厚、直径大于1.0 cm的息肉以及取代胆囊腔的实性肿块。晚期肿瘤常具有浸润性，由于其体积较大，在CT和MRI上可能难以鉴别。确定病变的起源对于缩小鉴别诊断范围至关重要，但往往具有挑战性。识别胆囊癌并将其与其他良性和恶性肝胆疾病区分开来很重要。由于手术切除是唯一的治愈性治疗选择，放射科医生对淋巴结和浸润性肿瘤扩散途径的理解和解读可以指导手术，或排除可能无法从手术中获益的患者。虽然CT和MRI都有效，但MRI能更好地对胆囊和胆管树进行软组织特征分析，是诊断、分期和评估治疗反应的有用影像学工具。RSNA，2020年。
