Primary carcinoma of bile duct is uncommon but not rare and its prognosis is poor. In the diagnosis of tumor induced bile duct obstruction, ultrasonography and CT are widely used for the evaluation of biliary obstruction.
The authors presented 47 cases of bile duct cancer, which were diagnosed by ultrasonography and CT at Dong-A University Hospital from March 1991 to February 1993.
@ES The results were as follows.
@EN 1. The detection rate of mass by ultrasonography was 95% and the diagnostic accuracy was more than 90%.
2. The most prevalent age group was in 7th decade and male-to-female ratio was 3:2.
3. Associated diseases were gallstone in 15 cases and clonorchiasis in 9 cases.
4. The locations were in CBD(51%), CHD(23%), Hilum(17%), IHD(9%) and etc.
5. The echogenecity of bile duct carcinoma compare to liver parenchyma was hyperechoic in 14 cases(30%), hypoechoic in 25 cases(52%), isoechoic in 6 cases(13%), and mixed echoic in 2 cases(5%).
6. The CT density of bile duct carcinoma compare to liver parenchyma was low in all cases(100%). In cases of peripheral type, there were low density mass with peripheral enhancing rim, regional ductal dilatation, and marginal atrophy of the
involved
liver.
7. The courses of extrahepatic lymphatic spread were three; 1st course was Foramen of Winslow lymph node chain and 2nd course was superior pancreaticoduodenal lymph node chain and 3rd course was posterior pancreaticoduodenal course, In different
biliary level, there were different spread courses.
|