Sasaki F, Kido C, Ariyoshi Y
Department of Diagnostic Radiology, Aichi Cancer Center Hospital.
Nihon Igaku Hoshasen Gakkai Zasshi. 1993 Feb 25;53(2):163-70.
To assess the differences in CT findings among patients with peripheral cholangiocarcinoma with and without a history of Thorotrast administration, CT studies from 13 Thorotrast patients and eight non-Thorotrast patients were reviewed. Diagnostic and prognostic differences were evaluated between the two groups. Despite periodic imaging surveillance, eight of the 13 (62%) lesions discovered by CT were larger than 6 cm. The prognosis for Thorotrast patients was unfavourable due to difficulties in early detection and complications from associated hepatic fibrosis. The main problem with early detection was that a background of uneven Thorotrast deposits visualized in the liver disguised the tumor as Thorotrast granulations. Although non-Thorotrast patients were not monitored regularly, they had a better chance of undergoing curative resection for the following three reasons: 1) it was easy to detect the tumor (detection rate, 100%); 2) this group rarely had associated liver cirrhosis in noncancerous areas, and 3) non-Thorotrast patients were younger than Thorotrast patients. Early detection of cancer by CA19-9 assay and imaging in asymptomatic subjects without any history of liver disease could be important steps toward the early and radical resection of cancer to achieve a better prognosis.
为评估有和没有钍造影剂注射史的周围型胆管癌患者的CT表现差异，回顾了13例钍造影剂患者和8例非钍造影剂患者的CT研究。评估了两组之间的诊断和预后差异。尽管进行了定期影像学监测，但CT发现的13个病变中有8个（62%）直径大于6 cm。钍造影剂患者的预后不佳，原因是早期检测困难以及相关肝纤维化的并发症。早期检测的主要问题是肝脏中可见的不均匀钍造影剂沉积背景将肿瘤伪装成钍造影剂颗粒。虽然非钍造影剂患者没有定期监测，但他们有更好的机会接受根治性切除，原因如下：1）肿瘤易于检测（检出率为100%）；2）该组在非癌区域很少有相关肝硬化；3）非钍造影剂患者比钍造影剂患者年轻。对于没有任何肝病病史的无症状受试者，通过CA19-9检测和影像学进行癌症早期检测可能是实现癌症早期根治性切除以获得更好预后的重要步骤。
