多层螺旋CT在肝外胆管梗阻病变诊断中的应用

目的：探讨多层螺旋CT（MSCT）在肝外胆管梗阻病变中的应用价值。方法回顾性分析经手术、病理以及临床随访证实的均做了CT检查的肝外胆管梗阻病变51例，其中良性41例，恶性10例。结果肝外胆管梗阻性病变中，良性多表现为肝内胆管呈枯枝状或残根状轻、中度扩张，梗阻部胆管呈漏斗样改变，肝外胆管壁呈环形弥漫性增厚；恶性多表现为肝内胆管呈软藤状中、重度扩张，梗阻部胆管呈截断型或突然狭窄并伴肿块，肝外胆管壁呈环形局限性增厚。结论良恶性肝外胆管梗阻病变均有其特征性的CT征象，注意观察胆管的形态改变，以及与周围组织结构的关系，结合临床综合分析，有助于提高诊断的准确性。

Multislice CT in the diagnosis of extrahepatic bile duct obstruction disease

Objective To evaluate the application value of multislice CT （MSCT） in the the extrahepatic bile duct obstruction. Methods Retrospectively analyze 51 cases with the extrahepatic bile duct obstruction confirmed by surgery, pathology and clinical follow-up who underwent CT examination. Of 51 cases, 41 cases were benign, 10 cases were malignant. Results For the extrahepatic bile duct obstructive lesions, the benign lesions mostly displayed as intrahepatic bile duct twigs or residual roots with light, moderate expansion, obstruction of bile duct showed funnel model change, the extrahepatic bile duct wall with ring-like diffuse thickening;The malignant lesions mostly displayed as intrahepatic bile ducts being soft in the vines, severe expansion, obstruction of bile duct was truncated or suddenly narrowed with lump, extrahepatic bile duct wall in annular had thickening limitations. Conclusion The benign and malignant extrahepatic bile duct obstruction were the characteristic CT signs, paying attention to the morphology of bile duct changes, as well as the relationship with the surrounding tissue structure, combined with clinical comprehen-sive analysis, can improve the accuracy of diagnosis.