CT与MRI诊断胆囊副神经节瘤案例分析

吕高星; 赵建华

doi:10.15953/j.ctta.2023.193

CT与MRI诊断胆囊副神经节瘤案例分析

吕高星^1,,
赵建华^2, ,

1.
内蒙古医科大学研究生院，呼和浩特010110
2.
内蒙古自治区人民医院影像医学科，呼和浩特010017

详细信息

作者简介:
吕高星: 男，内蒙古医科大学在读硕士研究生，主要研究方向为腹部肿瘤影像学，E-mail：1938898740@qq.com

通讯作者:
赵建华: 男，内蒙古自治区人民医院影像医学科主任医师、硕士研究生导师，主要从事腹部影像诊断研究，E-mail：zjh2822yyjh@163.com。

中图分类号: R 816.5
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出版历程
- 收稿日期: 2023-10-23
- 修回日期: 2024-02-21
- 录用日期: 2024-03-10
- 网络出版日期: 2024-04-25
- 刊出日期: 2024-09-04

CT and MRI Diagnosis of Gallbladder Paraganglioma: A Case Analysis

LYU Gaoxing^1,,
ZHAO Jianhua^2, ,

1.
Graduate School of Inner Mongolia Medical University, Hohhot 010110, China
2.
Department of Imaging Medical, Inner Mongolia Autonomous Region People's Hospital, Hohhot 010017, China

摘要

摘要:
胆囊副神经节瘤（GB-PGL）是一类罕见的神经内分泌肿瘤，由于临床表现并无特异性，对临床医生进行诊断和治疗造成困扰。本文报道我院收治的1例经手术病理证实的胆囊副神经节瘤患者，回顾性分析该病例的影像学表现及临床资料，旨在总结出此种罕见病的CT及MRI表现，为临床胆囊肿瘤精准治疗提供帮助。
- 体层摄影术 /
- X线计算机 /
- 磁共振成像 /
- 胆囊副神经节瘤
Abstract:
Gallbladder paraganglioma (GB-PGL) is a rare neuroendocrine tumor that is difficult to diagnose and treat due to its non-specific clinical manifestations. In this study, we described a case of gallbladder paraganglioma confirmed by surgical pathology in our hospital. We retrospectively analyzed the associated imaging and clinical data and summarized the CT and MRI manifestations of this rare disease. Our findings may assist with the precise treatment of gallbladder tumors in clinical practice.
- tomography /
- X-ray computer /
- magnetic resonance imaging /
- gallbladder paracanglioma

HTML全文

图 1 GB-PGL增强CT图像

注：CT平扫（a）主要呈等密度，伴中心少许稍低密度影（白箭）；增强扫描动脉期（b）显示病灶呈现明显不均匀强化；（c）和（d）门脉期及延迟期强化程度减低，但略高于周围肝实质，中心稍低密度区在动脉期呈弱强化，在门脉期及延迟期呈渐进性明显强化。动脉期还可见增粗的胆囊动脉及肝门区新发淋巴结（白箭头）。

Figure 1. GB-PGL contrast-enhanced CT images

下载: 全尺寸图片幻灯片

图 2 GB-PGL患者增强MRI图像

注：T1WI（a）肿瘤呈不均匀低信号，轴位与冠状位T2WI（b）和（c）可见肿瘤主要呈高信号（白箭），其内可见斑条状低信号影（黑箭）混杂，形似“盐-胡椒状”；T1WI同相位（d）肿瘤信号强度低于反相位（e）；DWI（f）强化方式与T2WI相似，肿瘤内低信号影显示欠佳；T1WI增强扫描动脉期（g）显示肿瘤呈不均匀明显强化，门脉期（h）及延迟期（i）强化程度减低，但略高于肝实质强化，而肿瘤内T2WI低信号区在动脉期强化不明显，在门脉期及延迟期较明显强化。

Figure 2. GB-PGL contrast-enhanced MRI images

下载: 全尺寸图片幻灯片

图 3 GB-PGL术后镜下病理

注：HE染色（×400）显示主细胞排列成束、簇状，呈多边形，胞质嗜酸性淡染，核小，圆形，间质见丰富的血窦。

Figure 3. Postoperative Microscopic Pathology of GB-PGL

下载: 全尺寸图片幻灯片

表 1 胆囊副神经节瘤（GB-PGL）影像学表现

Table 1 The imaging findings of gallbladder paraganglioma

诊断要点	影像学表现
位置	好发部位依次为胆囊底部→体部→颈部
黏膜完整性	肿瘤大多起源于浆膜下结缔组织内的副神经节细胞，通常覆盖黏膜完整，不受累及
信号/密度特征	CT：平扫呈低密度，增强扫描动脉期肿瘤主体呈现不均匀明显强化，静脉期及延迟期肿瘤主体强化程度减低，中心低密度区延迟明显强化 MRI：T1WI低信号，T2WI不均匀高信号（盐-胡椒征）；增强扫描同CT增强扫描各期相似；DWI呈不均匀高信号，与T2WI相仿
血供情况	富血供，可在肿块周边见到扩张的胆囊动脉，增强后明显强化
侵及肝脏频率	较胆囊癌更易侵及肝脏，形成肝脏大面积异常灌注区，肝转移瘤特征为环形强化，弥散受限
淋巴结转移	较胆囊癌更易发生淋巴结转移

下载: 导出CSV

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