三维螺旋CT胆道造影的临床应用

目的：评价三维螺旋ＣＴ胆道造影的诊断价值。方法：在静脉输入胆道造影剂Ｂｉｌｉｓｃｏｐｉｎ后，４２个病人进行了上腹部螺旋ＣＴ扫描，利用三维重建技术对胆道系统正常、正常变异及部分病变进行分析研究，并将其结果与两天之内进行的ＥＲＣＰ进行比较。结果：三维螺旋ＣＴ胆道造影准确地诊断胆道系统所有的正常、正常变异及所有的胆道梗阻、胆道结石，但在胆道结石的定量诊断方面有２（２／６）个病人的结石数量被低估；一个病人三维螺旋ＣＴ胆道造影仅诊断出胆总管结石而未能诊断出胆囊癌，但轴位图象可以清楚地显示出胆囊癌。模拟内窥镜方式可以更加直观地显示病变。结论：三维螺旋ＣＴ胆道造影可以作为一种准确而无创性的胆道系统检查方法。

Clinical Applications of Three dimensional Helical CT Cholangiography

Objective:To evaluate the accuracy of three dimensional helical CT cholangiography in the diagnosis of biliary disease.Methods:After infusion of Biliscopin,42 patients with suspected biliary disease underwent single breath hold upper abdominal helical CT acquisition.With prototype software,three dimensional CT cholangiography was reconstructed.They then underwent Endoscopic Retrograde Cholangiography examinations within two days.The results of helical CT cholangiography were compared with that at Endoscopic Retrograde cholangiography.Results:Helical CT cholangiography correctly diagnosis normal,normal variant of the biliary tree and biliary obstruction in all the patients.But the number of the biliary calculi was underestimated at CT choloangiography in two patients.In the patient with gallbladder carcinoma,the diagnosis was not obtained at only three dimensional CT cholangiography,but the carcinoma could be demonstrated clearly on source image.The lesions could be visualized at the VE in a more realistic fashion.Conclusion:Helical CT Cholangiography could be a noninvasive accurate procedure in the diagnosis of biliary disease.