Päivänsalo M, Oikarinen H, Tikkakoski T, Puumala K, Suramo I
Department of Diagnostic Radiology, University Hospital of Oulu, Finland.
Rofo. 1993 Jul;159(1):4-9. doi: 10.1055/s-2008-1032712.
Radiological findings in 58 cases of pathologically proven bile duct carcinoma were analysed retrospectively. 11 patients had peripheral intrahepatic cholangiocarcinoma, 30 either hepatic duct or choledochal carcinoma and 17 carcinoma of the papilla of Vater. The tumour was local abdominally in 41 and spread abdominally in 17 cases. All cases but one were examined by US, 27 by CT, 19 by PTC, 28 by ERCP and 11 by angiography. US showed bile duct obstruction in all the cases in which it was present and CT in 94%. US showed the primary tumour in 63% and CT in 44%, while the figures for showing abdominal spread were 56 and 17% respectively. No tumour mass was found at US in 28% of cases or at CT in 52%. ERCP failed in 3 out of 28 cases, showed a tumour in 24 (86%) and showed ambiguous narrowing of the bile duct in one. PTC showed obstruction or narrowing of the bile duct caused by a tumour in all cases, while angiography detected all the intrahepatic cholangiocarcinomas but was abnormal in only 2 out of 6 cases of extrahepatic bile duct carcinoma.
回顾性分析58例经病理证实的胆管癌的放射学表现。11例为肝内周围型胆管癌，30例为肝管或胆总管癌，17例为 Vater 壶腹癌。41例肿瘤局限于腹部，17例发生腹部转移。除1例患者外，所有病例均接受了超声检查，27例接受了CT检查，19例接受了经皮肝穿刺胆管造影（PTC），28例接受了内镜逆行胰胆管造影（ERCP），11例接受了血管造影。超声检查显示所有存在胆管梗阻的病例均有胆管梗阻表现，CT检查的显示率为94%。超声检查发现原发性肿瘤的比例为63%，CT检查为44%，而显示腹部转移的比例分别为56%和17%。28%的病例超声检查未发现肿瘤肿块，52%的病例CT检查未发现。28例ERCP检查中有3例失败，24例（86%）显示有肿瘤，1例显示胆管有可疑狭窄。PTC检查显示所有病例均有肿瘤导致的胆管梗阻或狭窄，血管造影检查发现了所有肝内胆管癌，但6例肝外胆管癌中只有2例异常。
