MSCT Of Focal Adenomyomatosis Of Gallbladder Of A Preliminary Study On The Classification And The Differential Diagnosis Value

Objective Investigate MSCT of focal adenomyomatosis of gallbladder(GBA)classification and differential diagnosis value of images.Materials and Methods Collected in our hospital between January 2007-December 2014 confirmed by histopathology of 59 patients with local thickening of gallbladder disease as the research object. According to the histological results are divided into four groups: group A(focal GBA) and group B(localized gallbladder cancers), group C(wide basal polyps), group D(limitations of chronic cholecystitis).Focal GBA of 37 cases, male 21 cases, female 16 cases, aged 37-81, an average of 57.Localized gallbladder cancers of 9 cases, 3 cases of male, female 6 cases, aged 49-85,the average age of 68. Wide basal polyps in 7 cases, 5 cases male, female in 2 cases,age 33-76, the average age of 48. Limitation of 6 cases with chronic cholecystitis,male in 2 cases, female 4 cases, aged 48 to 83 years old, average 67 years old. 59 underwent MSCT scan, multiphase enhancement scanning, any enhancement cases original data row CT thin layer reconstruction and multiple plane restructuring,according to CT manifestations, focal GBA can be divided into four type: 10 cases of basal type, wall type in 3 cases, 22 cases of nipple type, mixed type 2 cases.Comparing focal GBA and localized gallbladder cancer, wide basal polyps and limitations of chronic cholecystitis scan general information(age, gender,accompanying symptom, stones, combination of cholesterol crystals, the combining of chronic inflammation) and enhanced CT performance(including lesions border,adjacent wall thickening, with or without inner mucosal surface strengthening,strengthening form whether evenly, enhanced the RAS indicates whether or not),using SPSS17.0 software to chi-square test, and statistical analysis.Results(1) Basal type: bonnet, half ring at the bottom of the gallbladder or flat mild thickening, wall type: at the bottom of the localized thickening of the lumen uplift, nipple type: at the bottom of the thickening in papillary outside the cavity is outstanding, mixed type: thickening of the bottom at the same time to the internal and external cavity uplift. Various cases in both scan and multiphase enhancement scanning distribution within the thickened wall of multiple RAS, inner mucosal surface obviously homogeneous enhancement in "rosery" sign.(2) Scan the general data analysis results A(focal GBA), B(localized gallbladder cancers), C(wide basal polyps), D(limitations of chronic cholecystitis) four groups of cases in age, sex,with differences of symptom, stone has no statistical significance(P > 0.05), the merger of cholesterol crystal has A(focal GBA) and B(localized gallbladder cancers),C(wide basal polyps), D(limitations of chronic cholecystitis) group had obvious statistical significance(P < 0.05), the combination of chronic inflammation in group A(focal GBA) and group B(localized gallbladder cancers) and D(limitations of chronic cholecystitis) have obvious statistical significance(P < 0.05), compared with group C(wide basal polyps) had no statistical significance(P > 0.05);(3) Four groups of cases enhanced CT performance analysis(including lesions border, adjacent wall thickening, with or without inner mucosal surface strengthening, strengthening form is uniform, and enhanced the RAS indicates whether or not) the results showed that the group A(focal GBA) boundary limitations lesions with clear boundary in the other group, lesions can be found in the gallbladder and the adjacent wall thickening of the localized gallbladder cancers and limitations of chronic cholecystitis, inner lining, even to improve more common in focal GBA(p < 0.05), while the RAS restricted to focal GBA.Conclusion Focal adenomyomatosis of gallbladder CT classification is expected to provide reference for clinical treatment and surgery scheme; Spiral CT multi-phase scan and multiplanar recombinant technology is advantageous to the RAS, according to the clinical value of diagnosis and differential diagnosis with high; RAS, inner enhancement, "rosery" sign diagnosis is important sign of focal adenomyomatosis of gallbladder.