摘要目的:探讨淋巴上皮瘤样肝内胆管癌（LEL-ICC）的MRI表现。方法:回顾性分析复旦大学附属中山医院2011年3月至2021年3月经病理证实的26例LEL-ICC患者的MR图像；MR图像分析包括病灶的数量、位置、大小、形态、边缘，平扫信号强度、囊变坏死、强化方式、强化峰值、强化包膜、血管受侵、淋巴结转移等；测量病灶表观扩散系数（ADC）值及周围正常肝实质ADC值；计量资料采用配对样本 t检验进行统计学分析。 结果:26例LEL-ICC均为单发病灶，肿块型LEL-ICC最常见［ n=23，病灶大小（4.02±2.32）cm］；沿胆管分布型LEL-ICC［ n=3，病灶大小（7.23±1.40）cm］。肿块型LEL-ICC 23枚病灶中，大多数病灶紧贴肝包膜（ n=20），类圆形（ n=22），边界清晰（ n=13），囊变坏死（ n=22）。沿胆管分布型LEL-ICC 3枚病灶中，大多数紧贴肝包膜（ n=2），不规则形（ n=3），边缘模糊（ n=3），囊变坏死（ n=3）。26枚病灶T 1WI均呈低/稍低信号，T 2WI均呈高/稍高信号，DWI均呈稍高或高信号。3枚病灶呈快进快出强化方式，23枚病灶呈持续性强化方式；25枚病灶强化峰值出现在动脉期，1枚病灶强化峰值出现在延迟期。26例病灶的ADC值为（1.112±0.274）×10 -3 mm 2/s，邻近正常肝实质ADC值为（1.482±0.346）×10 -3 mm 2／s，二者差异有统计学意义（ P＜0.05）。 结论:LEL-ICC的磁共振影像表现具有一定的特征性，有助于诊断及鉴别诊断。

abstractsObjective:To investigate the MRI manifestations of lymphoepithelioma-like intrahep cholangiocarcinoma (LEL-ICC).Methods:MR images of 26 cases with LEL-ICC confirmed pathologically at Zhongshan Hospital Affiliated with Fudan University between March 2011 and March 2021 were retrospectively analyzed. The number, location, size, morphology, edges of lesions, non-scan signal intensity, cystic necrosis, enhancement mode, peak, and capsule, vascular invasion, lymph node metastasis, and other MR images were included for analysis. The apparent diffusion coefficient (ADC) value of the lesion and the surrounding normal liver parenchyma were measured. A paired-sample t-test was used to statistically analyze the measurement data. Results:All 26 cases of LEL-ICC had solitary lesions. Mass-type LEL-ICC was the most common [ n=23, lesion size (4.02±2.32) cm] with distribution along the bile duct [ n=3, lesion size (7.23±1.40 cm)]. Among the 23 lesions of mass type LEL-ICC, most of the lesions were close to the liver capsule ( n=20), round ( n=22), clearly bordered ( n=13), and cystic necrosis ( n=22). In the three lesions of LEL-ICC distributed along the bile duct, most of them were close to the liver capsule ( n=2), irregular ( n=3), blurred edges ( n=3), and cystic necrosis ( n=3). All 26 lesions showed a low/slightly low signal on T 1WI, a high/slightly high signal on T 2WI, and a slightly high or high signal on DWI. Three lesions showed fast-in and fast-out enhancement modes, and 23 lesions showed continuous enhancement. Twenty-five lesions showed peak enhancement in the arterial phase, and one lesion appeared in the delayed phase. The ADC value of 26 lesions and adjacent normal liver parenchyma was (1.112±0.274)×10 -3 mm 2/s and (1.482±0.346)×10 -3 mm 2/s, respectively, and the both had a statistically significant difference ( P<0.05). Conclusion:Certain manifestations of LEL-ICC in magnetic resonance imaging are advantageous for diagnosis and differential diagnosis.