20xx年醫(yī)學(xué)專題—肝內(nèi)膽管錯(cuò)構(gòu)瘤-預(yù)覽頁
【正文】 ～9.0％，其中 1ａ型為膽總管囊狀擴(kuò)張、肝總管不擴(kuò)張，膽囊管與囊腫相連；1ｂ型肝外膽管的膽總管段局部擴(kuò)張；1ｃ型為肝外膽管擴(kuò)張； 2型：真性膽總管憩室，約占２％； 3型：膽管囊腫僅累及膽總管十二指腸壁內(nèi)段，僅為４％～５％； 4型：肝內(nèi)外膽管均擴(kuò)張，占19％，其中 4ａ型為多發(fā)肝內(nèi)外膽管囊腫，4ｂ型為多發(fā)肝外膽管囊腫； 5型：即Caroli病。shēng)） large cyst in the right lobe of the liver. No perceptible wall is seen. (B) Axial portal venous phasecontrast materialenhanced CT image in the same patient shows homogeneous, rounded, welldefined, nonenhancing appearance of the lesion. (C) Axial T2 demonstrates homogeneous hyperintense signal intensity of the lesion with presence of few smaller additional hepatic cysts. (D) Post administration of gadoliniumchelates, no enhancement of the cyst wall or its content is identified on this fatsuppressed T1WI.,第十六頁，共三十頁。 特征性表現(xiàn)為肝內(nèi)大膽管非梗阻性、交通性囊狀或梭狀擴(kuò)張，本病分兩型：1型特點(diǎn)是伴復(fù)發(fā)性膽管炎，但無門靜脈周圍纖維化； 2型更常見，伴隨先天性肝纖維化。,第十八頁，共三十頁。,單房或多房性肝膿腫： 在增強(qiáng)CT或MRI中肝膿腫具有一定的特征性，除膿腫壁及房隔可見明顯的強(qiáng)化(qi225。)現(xiàn)象。ng)) liver abscess. (A) Axial portal venousphase contrastenhanced CT image obtained in a 52yearold woman with diverticulitis （憩室炎）shows a multiseptated（多分隔）,multiloculated（多腔）, welldefined abscess (arrow) in the right lobe of the liver. (B) Axial portal venousphase contrastenhanced CT image obtained in a 56yearold man presenting with fever and elevated white blood cell count shows a large, hypoattenuating lesion in the right hepatic lobe with thin peripheral enhancement and multiple septations.,第二十一頁，共三十頁。,第二十三頁，共三十頁。,(C) Axial portal venousphase contrastenhanced CT image obtained in a 58yearold woman shows several elliptic cystic lesions (arrows) on the surface of the liver. These lesions proved to be metastases from the patient’s known Ovarian（卵巢(luǎnch225。 肝內(nèi)膽管性錯(cuò)構(gòu)瘤臨床較為罕見，且無明顯臨床癥狀及體征，普通影像學(xué)表現(xiàn)無特異性，極易誤診為肝臟其他良性病變。 xie)！,第二十七頁，共三十頁。,第二十九頁，共三十頁。當(dāng)合并(h233
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