Han J K, Choi B I, Kim T K, Kim S W, Han M C, Yeon K M
Department of Radiology, Seoul National University College of Medicine, South Korea.
Radiographics. 1997 Nov-Dec;17(6):1475-85. doi: 10.1148/radiographics.17.6.9397459.
Hilar cholangiocarcinoma, a highly lethal tumor, is difficult to diagnose with conventional computed tomography (CT) because of its small size. Spiral CT allows more effective evaluation of these small lesions and better demonstrates the status of the hepatic arterial or portal venous circulation. Among 27 patients with hilar cholangiocarcinoma (infiltrative in 21, exophytic in two, polypoid in one, diffuse in three), thin-section spiral CT allowed identification of each tumor as an area of focal wall thickening that obliterated the lumen. Seventeen of the infiltrative tumors (81%) showed high attenuation. Identification of the level of biliary obstruction was possible in 63% of the patients (17 of 27). The level of obstruction was underestimated in six patients and overestimated in four. Spiral CT is a valuable method for diagnosis of hilar cholangiocarcinoma; however, spiral CT is less accurate in evaluation of intraductal tumor extent because of the limited z-axis resolution.
肝门部胆管癌是一种高度致命的肿瘤，由于其体积小，难以通过传统计算机断层扫描（CT）进行诊断。螺旋CT能够更有效地评估这些小病变，并能更好地显示肝动脉或门静脉循环的状况。在27例肝门部胆管癌患者中（浸润性21例，外生性2例，息肉样1例，弥漫性3例），薄层螺旋CT可将每个肿瘤识别为使管腔闭塞的局灶性管壁增厚区域。17例浸润性肿瘤（81%）表现为高密度。63%的患者（27例中的17例）能够确定胆管梗阻的部位。6例患者的梗阻部位被低估，4例被高估。螺旋CT是诊断肝门部胆管癌的一种有价值的方法；然而，由于z轴分辨率有限，螺旋CT在评估导管内肿瘤范围方面准确性较低。
