tailieunhanh - Diseases of the Gallbladder and Bile Ducts - part 3

Trên PET hoặc PET / CT scan, ung thư túi mật xuất hiện như tích lũy FDG cụ thể trong khu vực túi mật với phần mở rộng có thể vào gan. Các khối u Nâng cao có thể áp đặt lớn FDG dương tính đại chúng xâm nhập vào gan hoặc các cơ quan bụng liền kề | 80 Section 2 Diagnostic and therapeutic approaches for the biliary tree and gallbladder Figure Axial contrast-enhanced CT shows acute cholecystitis with evidence of calculi and gallbladder wall thickening greater than 3 mm. Figure Axial contrast-enhanced CT shows gangrenous cholecystitis with massive distension and gallbladder wall thickening greater than 3 mm. gradient echo images with fat suppression are commonly used to define the extent of invasion into the liver pancreas or duodenum 39 . On PET or PET CT scan gallbladder cancer shows up as specific FDG accumulation in the gallbladder area with possible extension into the liver. Advanced tumors may impose as large FDG-positive mass with infiltration into the liver or adjacent abdominal organs Plate 1 facing p. 84 . PET and PET CT scan have a high sensitivity to detect gallbladder can cer regardless of the primary or recurrent nature of the tumor Table . Although the study population is relatively small the three series which use PET scans to detect gallbladder cancer report a sensitivity of 75 to 80 and a specificity of 87 to 82 40-42 . Furthermore the PET scan proved to be an accurate method to differentiate benign disease such as cholecystitis gallstone disease and cholesterol polyp from gallbladder cancer 40 42 . Our experience in Zurich with the integrated PET CT scanner even demonstrated a sensitivity Chapter 4 Noninvasive imaging of the biliary system 81 A C B D Figure Coronal T2-weighted A unenhanced axial Tl-weighted B and gadolinium-enhanced axial Tl-weighted C images in a patient with acute cholecystitis. Note the wall thickening and the pericholecystic fluid arrows . Edema within the pericholecystic fat is best appreciated on MRCP image D . of 100 with a high median maximum standardized uptake value SUVmax of 43 . We also found PET CT very helpful in detecting distant metastases which were not visible by standard imaging. Bile ducts The intrahepatic bile ducts may not be .