原发性硬化性胆管炎14例临床X线分析

笔者分析了１４例原发性硬化性胆管炎的临床和Ｘ线表现，所有病例均符合Ｍｙｅｎｓ诊断标准，其中７例经手术病理证实。目前ＥＲＣＰ等直接法胆道造影被公认为此病的最佳检查方法，典型Ｘ线表现：（１）肝内胆管多发短带状狭窄，伴狭窄间小囊样扩张呈串珠状改变。（２）肝外胆管边缘不规整甚至呈憩室样突出。其他还有肝内胆管剪枝样改变和肝外胆管节段或弥漫性狭窄，而窄前胆管多无明显扩张。笔者还就此病的癌变、并发症和鉴别诊断等做了讨论。

Clinical X-ray Analysis on 14 Cases of primary Sclerosing Cholangitis

The clinical and X-ray findings of 14 cases of primary sclerosing cholangitis (PSC)were analysed.All of these were in accordance with Myens diagnostic criteria 7 were proved by operationstudy.Direct cholangiography espeially ERCP is one of the best methods for diagnosing PSC at present.Tytpical findings included:(1) multiple short bandlike structures alternated with saccular dilatation with abeaded appearance of intrahepatic duct;(2) markedly irregular margin with diverticulumlike outpouchingof extrahepatic duct.Other cholangiographic findings consisted pruning of intrahepatic duct with onlycentral brunches filled; segmental or diffuse structures of extrahepatic duct without obvious prestenoticdilatation. The possibility of malignancy;differential diagnosis;complicating diseases and other relatedproblems were discussed.