改进ERCP后CT扫描技术对阻塞性黄疸诊断的评价

目的 :探讨不同的ERCP后CT扫描技术对阻塞性黄疸的诊断价值。方法 :81例病人按照一定的标准在ERCP检查后 1/ 2～ 2h内进行CT横断面扫描。 5 3例病人采用普通CT机 ,后 2 8例病人采用多层螺旋CT扫描。按四分法分别对普通CT和多层螺旋CT图象质量和对病变的显示情况进行评价。结果 :普通CT图象优质的病例为 3 4% ,多层螺旋CT为 5 7.1% ,后者明显好于前者 ,利用多种三维重建法重建出的胆胰管树与ERCP的胆胰管树结构一致 ,用CT仿真内窥镜技术可以显示突向腔内的结节。普通CT图象质量较差的9例 (17% )是由于造影剂星状伪影、肠道大量气体及病人闭气不严所致。普通CT及多层螺旋CT诊断正确率分别为 92 .7% (5l/ 5 5例 )和 94.4% (2 7/ 2 8例 )。结论 :改进ERCP后CT扫描技术有助于改善图象质量和充分显示病变特点。

The effection of improved CT scanning closely-following ERCP on the diagnosis of obstructive jaundice

Objective: To investigate the value of differente CT scan methods closely-following ERCP for the diagnosis of obstructive jaundice.Methods: CT scanning within half to 2 hours after ERCP were performed in 8 l patients with obstructive jaundice, which were done by conventional CT in 53 cases and multi-slice spiral CT in later 28 cases. The image quality and menifestations of biliary-pancrease diseases were compared in this two kinds of CT scanning methods.Results: The multi-slice spiral CT wes superior to conventional CT in the aspects of both image quality and visibility of lesions in obstructive jaundice, and its biliarytrees reconstructed by three dimension mimik the images of ERCP. The tumor withinbiliary duct could be “seen” directly through CT virtual endoscopy.The poor images in convertional CT were caused mostly by high-density contrast materials, large amount of gas in bowels and moving artifects.Conclusion: Multi-slice spiral CT closely-following ERCP wes more valuable than convertional CT in the diagnosis of obstructive jaundice.