壶腹周围癌的CT诊断

目的：探讨壶腹周围癌的CT表现及其诊断价值。材料和方法：分别选取经手术和／或病理证实的壶腹周围癌23例，其中胆总管远端癌6例．胰头钩突癌(直径≤3cm)7例，壶腹癌8例．十二指肠乳头部癌12例．着重分析该部位肿瘤所共有CT直接与间接征象以及各种不同肿瘤的特征性CT表现．并与US，ERCP、PTC等影像技术进行比较．结果：壶腹周围癌的直接CT征象为胰头钩突区，胆总管远端或十二指肠乳头部的较组轵块影．显示率达91.3％．胰头钩突癌的特征性CT表现为扩张的胆总管与主胰管(双管征)间距增宽．胆总管远端癌则表现为扩张的胆总管内结节及肿块与胆总管间无界面。十二指肠乳头部癌与壶腹癌二者不易区别，十二指肠腔内缺损及合一的双管征则是典型表现．本组术前CT定性诊断符合率达86．9%．结论：运用CT检查诊断壶腹周围癌是有效而准确的方法。     

图象诊断与早期胰腺癌

早期胰腺癌的定义尚不明确,当胰癌局限于胰管上皮而没有实质浸润者可考虑为早期胰癌。作者报告183例胰癌,均为胰管上皮发生的胰癌,经手术、尸检和组织学证实。男女比109:74,平均年龄62岁,位于胰头112例,体尾部63例,全胰腺8例。T_1(<2cm)19例、T_2(2.1～4cm)35例,其余129例在4cm以上。T_119例中胰头癌占13例,体尾癌6例。作者见到,19例T_1胰癌图像显示率为:超声5/9(63％),CT7/9(78％),ER-CP19/19(100％),血管造影17/18(91％)。超声虽容易判断尾侧胰管扩张,可做为诊断的线索,但应该用其他的检查方法鉴别胰癌和慢性胰腺     

ERCP、CT、B超对胰胆管下段疾病的诊断准确性

目的 比较ERCP、CT、B超对胰胆管下段疾病的诊断准确性。方法 100例临床表现为梗阻性黄疸，反复上腹痛、恶心呕吐的患均经ERCP、CT及B超检查本组患经手术病理或活检证实为良性病变(胆总管结石)57例，恶性肿瘤31例，其中胆总管癌11例，胰头癌13例，以及壶腹癌8例。上述3种方法术前的定性诊断准确率均与手术病理结果对照。结果 对胆总管结石的定性诊断准确率：ERCP为98％(n=56)，CT为72％(n=41)，B超为61％(n=35)；对恶性肿瘤的定性诊断准确率：ERCP为97％(n=31)，CT为78％(n=25)，B超为63％(n=20）。结论 ERCP对胰胆管下段良恶性病变的定性诊断准确率明显高于CT和B超，但因CT与B超均属无创性操作且对某些恶性肿瘤也有较高的定性诊断准确率，因此在影像诊断中应考虑3项技术优势互补。     

水灌肠^18F—FDGPET／CT在直肠癌诊断中的应用价值

目的探讨水灌肠^18F-FDGPET／CT检查在直肠癌诊断中的应用价值。方法回顾性分析69例[男52例,女17例;平均年龄57．9岁]临床怀疑为直肠癌患者的常规及水灌肠^18F-FDGPET／CT资料,与肠镜或术后病理结果进行对照,比较2种方法对直肠癌的诊断效能,同时比较不同病灶SUVmax的差异。采用配对t检验及McNemar检验对数据进行统计学分析。结果病理证实直肠癌61例,非直肠癌8例。61例直肠癌患者灌肠前后SUVmax差异有统计学意义（13．17±6．19与14．25±6．63;t=-6．100,P〈0．01）。常规PET／CT诊断直肠癌的灵敏度为90．2％（55／61）,特异性为4／8,准确性为85．6％（59／69）;水灌肠PET／CT相应指标为98．4％（60／61）,6／8,95．7％（66／69）,2种方法诊断直肠癌的准确性差异有统计学意义（x^2=5．140,P〈0．05）。结论水灌肠PET／CT弥补了常规PET／CT的不足,提高了对直肠癌诊断的准确性。     

多层螺旋CT在胰腺癌诊断中的应用

胰腺癌是常见的胃肠道恶性肿瘤之一,发病率呈逐年上升的趋势,预后极差,1年生存率<30%,5年生存率仅为3%～7%。螺旋CT增强扫描被认为是目前评价胰腺癌最常用、最准确的影像学检查方法之一。现回顾性分析26例胰腺癌患者多层螺旋CT多期扫描影像资料,评价其诊断价值。1资料与方法1.1一般资料收集经临床和手术病理证实的26例胰腺癌患者的8层螺旋CT多期扫描的影像资料,其中男17例,女9例,年龄38～79岁,平均58.3岁。其中16例胰头癌,5例胰体癌,2例胰尾癌,3例胰体尾部癌。1.2检查方法采用GELightspeedUltra型8层螺旋CT机,使用高压注射器,经前臂静…     

18F-FDGPET／CT联合腹部增强CT对诊断胰腺癌及评估肿瘤可切除性的临床应用

目的评价18F-脱氧葡萄糖（FDG）PET／CT联合腹部增强CT对诊断胰腺癌、鉴别诊断胰腺良恶性病变以及评估肿瘤可切除性的临床应用价值。方法回顾性分析行18F—FDGPET／CT和腹部增强CT检查并经病理检查或临床等方法证实的48例原发性胰腺病变患者的资料,其中胰腺癌34例,胰腺良性病变14例。对胰腺癌和胰腺良性病变患者最大标准摄取值（SUVmax）进行t检验;比较分析单独PET、腹部增强CT、PET／CT、PET／CT联合腹部增强CT4种方法的图像特征和诊断价值,对灵敏度和准确性进行x2检验,对特异性进行Fisher确切概率法检验。结果34例胰腺癌患者与14例胰腺良性病变患者的SUVmax（5．91±2．90和2．24±1．13）差异有统计学意义（t=4．56,P〈0．01）。PET／CT联合腹部增强CT诊断胰腺癌的灵敏度、特异性和准确性分别为97．1％（33／34）、92．9％（13／14）和95．8％（46／48）,与单纯PET的88．2％（30／34）、64．3％（9／14）和81．2％（39／48）相比,x2=0．863和P=0．352,P=0．038,X2=5．031和P=0．024;与腹部增强CT的76．5％（26／34）、71．4％（10／14）和75．0％（36／48）相比,x2=6．274和P=0．012,P=0．042,x2=8．362和P=0．003;与PET／CT的88．2％（30／34）、78．6％（11／14）和85．4％（41／48）相比,x2=0．863和P=0．352,P=0．048,x2=3．928和P=0．047。PET／CT全身显像几乎发现了全部转移灶,使14例胰腺癌患者避免了不必要的外科手术;PET／CT可对单独PET显像诊断的胰腺癌患者胰腺外假阳性病灶进行正确诊断,使1例胰头癌患者分期下调,进行了外科手术。腹部增强CT通过多期显像,可以准确判断肿瘤对胰腺周围主要血管的侵犯程度,腹部增强CT按血管受侵程度评估肿瘤可切除性的准确性为83．3％（15／18）,不可切除的准确性为9／9。结论PET／CT联合增强CT对于诊断胰腺癌、鉴别胰腺良恶性病变及评估肿瘤的可切除性准确性有一定临床价值。     

CT及MRI多模态参数对鉴别胰头部肿块型慢性胰腺炎与胰头癌的价值

目的分析胰头部肿块型慢性胰腺炎(MFCP)与胰头癌的CT以及MRI定性及定量表现,总结二者有效的影像鉴别特点。方法选取我院16例胰头部MFCP及16例胰头癌临床及影像资料进行回顾性分析。结果胰头部MFCP与胰头癌影像表现:1)肿块形态密度:分叶状(2例,11例),假性囊肿(11例,0例),肿块内钙化(6例,0例);2)DWI高信号:(2例,14例);3)静脉期相对低密度(3例,15例);ROC曲线分析示静脉期CT差值鉴别二者的AUC=0.852;4)胰胆管表现:主胰管扩张(9例,12例),胰管病灶处截断(1例,10例),胆总管扩张(6例,12例),胆总管病灶处截断(2例,10例),双管征(7例,11例),不相交征(1例,12例),肝内胆管扩张(2例,11例);5)周围组织表现:肾周筋膜增厚(9例,3例),胰周血管包绕受侵(1例,2例)。结论胰头部MFCP与胰头癌的影像学表现具有特异性,肿块的形态、DWI信号、胰胆管扩张程度及二者的血供特点有助于二者诊断及鉴别诊断。     

多层螺旋CT冠状动脉成像临床应用价值探讨

目的 探讨冠状动脉多层螺旋CT成像的临床应用价值。资料与方法 38例冠状动脉进行多层螺旋CT血管造影,利用多种重建方法进行重建,分析冠状动脉的成像质量及其显示率,以及冠状动脉疾病的影像特点。结果 图像质量的优良率：优28．9％(11／38),良60．5％(23／38),差10．5％(4／38),优良率为89．5％(34／38);冠状动脉分段显示率为：右冠状动脉近段100％(38／38),中段76．3％(29／38),远段60．5％(23／38);左冠状动脉前降支近中段100％(38／38),远段81．6％(31／38),左回旋支近段100％(38／38),远段55．3％(21／38)。发现冠状动脉管壁欠光滑18例,钙化8例,管腔充盈缺损2例,冠状动脉仿真内镜发现冠状动脉夹层1例,管腔狭窄3例。结论 多层螺旋CT冠状动脉成像可以作为冠心病的一种筛选手段。     

无黄疸型胰头癌的螺旋CT特征分析

收集26例无黄疸型胰头癌病例CT资料,分析CT表现特征,以提高对本病的认识和早期诊断。1材料与方法1.1临床资料搜集本院1999年1月~2005年6月共26例无黄疸性型胰头癌。男16例,女10例,年龄32~71岁,平均年龄52·6岁。所有病例均满足以下标准:①经1名消化内科高年资医师查体未发现皮肤、巩膜黄染者,且实验室检查血总胆红素(T.B.)正常或略高于正常值范围;②经手术、病理或临床、影像、实验室检查或者随访证实为胰头癌;26例无黄疸型胰头癌中,18例经手术及病理证实;其余8例经临床、实验室检查及影像学检查及随访综合诊断证实。23例(88·5%)T.B.5…     

壶腹癌的CT诊断

目的:回顾分析壶腹癌的CT表现,提高其诊断正确性.材料和方法:收集经CT检查后手术病理证实壶腹癌15例.全部病例均经GE9800或Elscint2400高分辨CT机行增强扫描,层厚、层距为5.0mm.结果:15例壶腹癌CT表现为1)胰头钩突肿块7例;2)十二指肠腔内充盈缺损8例;3)15例胆总管显著扩张合并下端截断性阻塞,同时合并肝内胆管、胆囊扩张11例;4)胰管扩张9例.根据壶腹癌占据部位在CT上提出分型:l)胰头钩突肿块型;2)十二脂肠乳头型;3)混合型.结论:改进CT检查技术,对早期诊断及提高壶腹癌诊断正确率有益.     

Integrated contrast-enhanced diagnostic whole-body PET/CT as a first-line restaging modality in patients with suspected metastatic recurrence of breast cancer

Objective(s)

Only few information exist about the diagnostic accuracy of PET/CT for restaging patients with metastatic recurrence of breast carcinoma. Therefore, our study hypothesis was to perform diagnostic contrast enhanced CT (ce-CT) and FDG-PET in a one-step investigation, to prove sensitivity of each modality and to determine whether diagnostic PET/CT adds information over PET or contrast enhanced CT alone for restaging of patients with suspected recurrence of breast cancer.

Methods

Fifty-two patients with suspected recurrence of breast cancer were included in our study. All of them were free of metastasis after the first line therapy. Indications for restaging were: Elevated tumor markers n = 32, clinical deterioration n = 16 and/or suspicious findings on other imaging studies n = 48. Integrated PET/CT was performed using contrast-enhanced diagnostic CT for attenuation correction.

Results

PET was correct in 44/52 patients (85%), ce-CT in 38/52 patients (73%) and PET/CT in 50/52 patients (96%). Sensitivity and specificity of lesion detection of PET, CT and PET/CT were 84%, 66% and 93%, and 100%, 92%, and 100%, respectively.

Discussion

PET/CT can improve staging and alter therapeutic options in patients suspected to have breast cancer recurrence and distant metastatic disease, primarily by demonstrating local or distant nodal involvement occult at other imaging studies. The added value of FDG-PET/CT over other diagnostic modalities is mainly expressed by the fact that a noninvasive whole-body evaluation is possible in a single examination.     

Transhepatic cholangiography: the radiological method of choice in suspected obstructive jaundice.

Twenty-five patients with severe jaundice were studied prospectively with computed tomography (CT), gray-scale ultrasonography (USG), and percutaneous transhepatic cholangiography (THC). Nineteen had obstruction of the biliary tree. The differentiation of obstructive from hepatic parenchymal causes of jaundice was 72% accurate with USG, 92% with CT, and 96% with THC. Biochemical studies when used alone were 72% accurate. Although the precise location of an obstructing lesion was determined in 12/19 cases by CT and 9/19 by USG, the cause was established in only 5 by CT and 7 by USG. THC was 100% successful in establishing both cause and site of obstructive jaundice without significant complications.     

弥漫性肺疾病的VHRCT、MIP、MinIP诊断价值

目的　探讨容积高分辨率CT(VHRCT)、最大强度投影 (MIP)及最小强度投影 (MinIP)对弥漫性肺疾病 (DLD)的诊断价值。材料与方法　对 112例DLD患者行肺部感兴趣区VHRCT扫描及MIP、MinIP重建 ,其中 46例同期进行肺功能检查。全部病例均经病理或临床综合诊断证实。结果　 ( 1)MIP图像显示肺结节、磨玻璃影、血管束异常和MinIP图像显示肺低衰减敏感性均为 10 0 %。分别根据常规螺旋CT(SCT)、SCT结合VHRCT ,以及SCT、VHRCT、MIP和MinIP 4种技术图像所见进行诊断 ,DLD诊断可信度水平逐步提高 (P <0 .0 0 1) ;可信度为 3的正确诊断率显著提高 [3 1.2 5 % ( 3 5 / 112 )、5 8.93 % ( 66/ 112 )、79.46% ( 89/ 112 ) ,P1、P2均 <0 .0 0 1] ;观察者之间的意见一致性逐步提高 (Kappa值分别为 0 .62 1、0 .73 9、0 .80 9)。( 2 )MinIP图像上肺低衰减评分与结合SCT图像的综合评分呈显著正相关 ( (r =0 .867,P <0 .0 0 1) ,均与大多数肺功能指标显著相关 (P <0 .0 5 )。结论　VHRCT扫描结合MIP、MinIP重建明显增加了诊断DLD的有用信息 ,可作为诊断DLD的一种很好的补充手段。MinIP图像检出肺低衰减比较敏感 ,其评分与肺功能指标明显相关 ,可作为预测肺疾病患者肺功能的指标之一。     

MR增强扫描在骨样骨瘤诊断中的临床价值

目的分析骨样骨瘤的X线、CT、MRI的影像表现,总结其影像学特征,比较不种影像学检查方法的诊断价值,优化检查,提高对骨样骨瘤的诊断及鉴别诊断能力。方法对我院经手术或穿刺病理证实的32例骨样骨瘤的影像学表现进行回顾性分析。男23例,女9例,男女之比2.61;年龄1.6~42岁,平均年龄9岁。13例同时行X线、CT、MRI检查,26例行X检查,21例行CT检查,20例行MRI检查,8例增强。结果32例骨样骨瘤中,有24例出现大小不一的圆形或椭圆形瘤巢,直径为0.28^-2.22cm,瘤巢周围伴有不同程度的骨质硬化。X线对瘤巢显示率为35%(9/26),4例瘤巢中心出现钙化;CT对瘤巢显示率为90%(19/21),出现钙化者16例,8例显示“血管沟征”;MRI平扫对瘤巢显示率为55%(11/20),增强MRI对瘤巢的显示率为100%(8/8)。20例MRI检查均显示不同程度的骨髓水肿。结论瘤巢是确诊骨样骨瘤的关键,MRI增强扫描对瘤巢的显示率不亚于CT,增强MRI检查在一定程度上能够准确地诊断骨样骨瘤,不用暴露于放射线就可定位瘤巢。     

Helical CT screening for hepatocellular carcinoma in patients with cirrhosis: frequency and causes of false-positive interpretation

OBJECTIVE: The purpose of our study was to determine the specificity of helical CT for depiction of hepatocellular carcinoma in a population of patients with cirrhosis. SUBJECTS AND METHODS: Single-detector helical CT screening was undertaken in 1329 patients with cirrhosis who were referred for transplantation. The patients underwent one or more helical CT examinations over 30 months and were followed up for an additional 19 months or until transplantation. We predominantly used unenhanced and biphasic contrast-enhanced techniques with infusions of 2.5-5.0 mL/sec. Four hundred thirty patients underwent transplantation within this period. Liver specimens were sectioned at 1-cm intervals, with direct comparison of imaging and pathologic findings and histologic confirmations of all lesions. Prospective preoperative helical CT reports were used for the primary data analysis. A retrospective unblinded review was undertaken to determine characteristics of false-positive lesions diagnosed as hepatocellular carcinoma. RESULTS: Thirty-five patients (8%) had false-positive diagnoses for hepatocellular carcinoma based on helical CT. Twenty of these patients (5%) showed hypoattenuating lesions seen during one of the three helical CT examination phases. Fifteen patients (3%) had hyperattenuating lesions seen during the arterial phase. Among the 15 hyperattenuating lesions, CT revealed the causes to be transient benign hepatic enhancement (n = 3), hemangiomas (n = 2), fibrosis (n = 2), peliosis (n = 1), volume averaging (n = 1), low-grade dysplastic nodule (n = 1), or undetermined (n = 5). Of the 20 hypoattenuating lesions, the causes were shown to be fibrosis (n = 8), focal fat (n = 4), infarcted regenerative nodules (n = 2), regenerative nodules (n = 1), fluid trapped at the dome of the liver (n = 1), hemangioma (n = 1), or undetermined (n = 3). Follow-up helical CT in 13 (72%) of 18 patients allowed a change in the diagnosis of hepatocellular carcinoma to a finding of no cancer present. CONCLUSION: Helical CT screening for hepatocellular carcinoma in patients with cirrhosis has a substantial false-positive detection rate. Although most of lesions were hypoattenuating, a few hyperenhancing arterial phase lesions were proven not to be hepatocellular carcinoma. An awareness of imaging characteristics and follow-up imaging can help radiologists avoid a mistaken diagnosis in many patients.     

The diagnosis of acute acalculous cholecystitis: a comparison of sonography, scintigraphy, and CT

The clinical and laboratory diagnosis of acute acalculous cholecystitis is difficult, and the reliability of various diagnostic imaging techniques has not been established. The results of several imaging procedures performed over a 6-year period on 56 patients with clinically suspected acute acalculous cholecystitis were evaluated retrospectively. Sonography and CT were both highly sensitive (92% and 100%, respectively) and specific (96% and 100%, respectively). Hepatobiliary scintigraphy was compromised by frequent false-positives; the result was a specificity of only 38%. Percutaneous bile aspiration was insufficiently sensitive (33%) for diagnosis. Sonography was as sensitive as hepatobiliary scintigraphy and was more specific in establishing the diagnosis. Because sonography is relatively inexpensive and can be performed at the bedside, it should be regarded as a satisfactory screening procedure. However, CT is a good alternative in an easily transported patient when other intraabdominal disease is suspected.     

几种影像学技术在诊断先天性尿路畸形中的价值

目的比较几种影像学技术在诊断先天性尿路畸形中的价值,并探索其最优化选择。方法收集1999年至2005年我院所检查的19例先天性尿路畸形患者,男4例,女15例,年龄1～53岁,平均17.2岁。其中,9例行静脉肾盂造影（IVP）,B超,CT,磁共振泌尿系成像（MRU）检查,6例行IVP,B超,MRU检查,4例行B超,CT检查。结果所有患者经手术病理证实,其中,左侧畸形6例,右侧畸形7例,双侧畸形6例。与手术病理所见比较,IVP,B超,CT,MRU明确诊断先天性尿路畸形例数分别为10例,10例,9例,8例,手术符合率分别为66.7%,52.6%,69.2%,53.3%。结论各种影像学技术在诊断先天性尿路发育畸形中各有所长,而优势互补,有助于提高诊断准确性。     

SPECT/CT骨显像对SAPHO综合征的诊断价值

目的探讨SPECT/CT骨显像在滑膜炎、痤疮、脓疱病、骨肥厚、骨髓炎（SAPHO）综合征诊断中的临床价值。方法回顾性分析临床怀疑SAPHO综合征的11例患者的临床资料及SPECT/CT骨显像结果,所有患者均行99Tcm-MDP全身骨显像+局部断层显像及同机或异机CT扫描,获得SPECT全身骨显像和局部SPECT骨显像、CT显像、SPECT/CT融合显像图像。分析比较SPECT骨显像和SPECT/CT融合显像对SAPHO综合征诊断的准确率、灵敏度和特异度,组间准确率的比较采用χ2检验。结果11例临床怀疑SAPHO综合征患者中,9例经穿刺组织病理或随访病情最终转归而确诊,另外2例为转移瘤。其中,SPECT诊断6例,共发现41个病灶出现放射性浓聚;SPECT/CT诊断9例,共发现44个病灶。SPECT骨显像的灵敏度、特异度和准确率分别为66.7%（6/9）、50.0%（1/2）和63.6%（7/11）;SPECT/CT融合显像的灵敏度、特异度和准确率分别为100%（9/9）、50.0%（1/2）和90.9%（10/11）,SPECT/CT融合显像对SAPHO综合症诊断的准确率明显高于单纯的SPECT显像,且差异具有统计学意义（χ2=11.82,P < 0.05）。结论SPECT/CT的联合应用提高了对病灶解剖定位的准确率及骨显像特异度,可用于SAPHO综合征患者的病灶精准定位、早期诊断与鉴别诊断、更多隐匿病灶检出以及病灶代谢活性评价等,对SAPHO综合征的诊断有较高的临床价值。     

Parathyroid adenoma screening efficacies of different imaging tools and factors affecting the success rates

PurposeWe aimed to compare the efficacy of three different parathyroid adenoma screening tools—high-resolution ultrasonography (USG), technetium Tc 99m-methoxyisobutylisonitrile (MIBI) parathyroid scintigraphy, and magnetic resonance imaging (MRI)—and we evaluated the factors affecting the detection success rates.MethodsParathyroid imaging was evaluated by USG, double-phase 99mTc-MIBI parathyroid scintigraphy, and cervical MRI in patients with hyperparathyroidism (n=39).ResultsAmong the 39 patients, USG, parathyroid scintigraphy, and MRI correctly identified 35 adenomas (89.7%), 28 adenomas (71.8%), and 26 adenomas (66.7%), respectively. Positive predictive values for USG (34/35), scintigraphy (27/28), and cervical MR (26/26) imaging were 97.1%, 96%, and 100%, respectively. Parathyroid adenomas were detected with 92.3% (36/39) certainty when both USG and scintigraphy modalities were applied together. Minimally invasive parathyroidectomy under local anesthesia with unilateral incision was successfully performed in 24 (61.5%) patients.ConclusionsMinimally invasive surgery for parathyroid adenomas has been developed and has equal success with traditional surgery. However, accurate localization of adenomas should be obtained prior to surgery. In this study, ultrasound was found to be effective in localizing adenomas for successful surgery. Adding other imaging modalities does not improve localizing the parathyroid adenomas.     

肝动脉化疗栓塞术后胆囊炎

目的：探讨肝动脉化疗栓塞（TACE）术后并发胆囊炎的影像特点、临床表现及病因。资料与方法：回顾性分析TACE术后并发胆囊炎患者的临床及影像资料，其中原发性和继发性肝癌138例，肝血管瘤4例，观察其胆囊动脉及胆囊血管造影表现；胆囊炎症状和体征；白细胞计数及分类；B超和／或CT胆囊形态变化。对于确诊为胆囊炎的患者，分析其所应用的化疗方案。结果：17例患者（肝癌14例，血管瘤3例）TACE后并发胆囊炎（12％），其中术后即刻血管造影示胆囊动脉和／或其分支闭塞，胆囊染色11例，发热17例，右季肋部疼痛17例，10例伴右肩部放射，Murphy征阳性17例。17例白细胞总数及中性粒细胞百分比均有明显增加。术后腹部B超（12例）、CT（5例）示胆囊壁增厚、水肿，胆囊窝渗出。14例TACE后并发胆囊炎的肝癌患者化疗方案为：BLM5例，DDP（或CP）4例，BLM＋DDP或CP2例，EADM3例；3例肝血管瘤患者仅用BLM。结论：TACE后胆囊炎的发生与胆囊动脉的解剖、导管尖端的位置、栓塞剂、化疗药等多种因素有关，应综合临床、影像、实验室检查等资料作出诊断，及时治疗，避免胆囊穿孔等严重并发症的发生。