Objective To analyze the clinical and CT imaging features of peripheral intrahepatic cholangiocarcinoma(PICC),and to discuss the causes of CT misdiagnosis and preventive measures.Methods The clinical data of 8 patients with misdiagnosed PICC admitted from February 2021 to January 2022 were retrospectively analyzed.Results Of the 8 pa-tients,3 had a history of biliary tract surgery,2 had a history of intrahepatic bile duct calculus,and 1 had a history of gall-stone.Cirrhosis was present in 4 patients.Eight patients presented with epigastrial discomfort or pain,and 4 patients had liver cirrhosis.Alpha-fetoprotein was elevated,and CT scan showed false envelope sign of intrahepatic mass,which was initially di-agnosed as hepatocellular carcinoma.In 2 patients,there was slight increase in body temperature,the lesion was weakly en-hanced in arterial stage by enhanced CT scan,honeycomb lesion was found during portal phase,and distal bile duct dilation and amputation sign were found,so the initial diagnosis was liver abscess.Two patients were initially diagnosed as hepatic he-mangioma due to cord-like enhancement of the lesion edge observed during the arterial phase,progressive enhancement during portal phase,and dilatation of adjacent bile duct on CT enhanced scan.Eight patients were diagnosed as PICC by percutane-ous liver biopsy and cytology,and left hemihepatectomy was performed in 5 patients and right hemihepatectomy in 3 patients.As for histological type,there were 5 patients with poorly differentiated adenocarcinoma and 3 patients with moderately differ-entiated adenocarcinoma.All patients survived and no metastases were observed during 2-year follow-up after discharge.Conclusion PICC is prone to misdiagnosis due to confusion with hepatic abscess,hepatocellular carcinoma and hepatic he-mangioma before operation.The clinicians should strengthen the understanding of the clinical and imaging characteristics of this disease,comprehensively analyze the condition in various aspects,and perform puncture biopsy or surgical and pathologi-cal examination as soon as necessary,which can improve the diagnosis rate.
维普
万方数据