胆道阻塞的CT诊断—与直接胆管造影的比较研究

本文对８２例手术病理证实的阻塞性黄疸作前瞻性ＣＴ诊断，并与直接胆道造影比较研究。发现胆管逐渐尖削，明显的肝外胆管壁环状增厚是良性阻塞可靠且特异的ＣＴ征象。肝内外胆管不一致扩张（内轻外重），扩张胆管腔内ＣＴ值大于２０ＨＵ对良性阻塞的判断有一定帮助。管突断伴或不伴肿块，胆管壁局根不规则增厚是恶性阻塞相对可靠且特异的ＣＴ征象。ＣＴ能清楚显示肝内胆管扩张及它们汇合处解部剖及变异。比较直接胆管造影，ＣＴ对肝

CT Diagnosis of Biliary Obstruction: A Comparative Study with Direct Cholangiography

Eighty two cases with obstructive jaundice proved by operation and pathology were prospectively diagnosed by CT, and compared with direct cholangiography(DC). The smooth tapering in obstructive segement of bile duct and the marked concentric wall thickening of extrahepatic bile ducts were the typical and specific CT findings for determining of benign obstruction. Disparate dilatation(marked in extrahepatic, mild in intrahepatic bile ducts) and CT value higher than 20HU within the dilated ducts were helpful for determining of benign obstruction. The abrupt termination of dilated bile duct with or without a mass and the focal eccentric wall thickening of bile ducts were the relatively typical and specific CT findings for determining of malignant obstruction. CT was capable of clearly showing the dilatation of intrahepatic radicals and the anatomy of their confluence and congenital abnormalities. Hilar obstruction was evaluated by CT more easily ,correctly and reliable than by DC. The accuracy of CT predicting of the level and cau se of biliary obstruction was the same as that of DC However,CT can correctly evaluate the resectability of malignant obstruction.