16层计算机断层摄影结合多平面重建技术在胆管阻塞病人中的应用

[目的]评价16层计算机断层摄影结合多平面重建技术在胆管阻塞病人中的应用。[方法]使用16层计算机断层摄影结合多平面重建技术(MPR)对60例被认为患有胆管阻塞的病人进行诊断。诊断中没有使用任何胆管造影剂。其中24例病人接受了磁共振胰胆管造影成像(MRCP)检查,16例病人进行了逆行胰胆管造影(ERCP)检查,28例病人进行了活组织切片检查或外科手术。我们将16层计算机断层摄影检查结果与磁共振胰胆管造影成像、逆行胰胆管造影、活组织切片检查及外科手术的结果进行了对比。以手术病理结果为标准。[结果]检查结果如下:胆总管结石(34例),恶性狭窄(14例),良性狭窄(2例),胆石症(12例)。1例病人的一枚小胆总管结石16层计算机断层摄影未能检出。2例16层计算机断层摄影初诊为胆管结石的病人在接受其他相关检查时诊断为恶性胆管狭窄。16层计算机断层摄影诊断胆管结石的准确率为91.1%。16层计算机断层摄影诊断胆管狭窄的准确率为87.5%。[结论]16层计算机断层摄影及多平面重建技术是一种快速和无创技术,在诊断胆管阻塞原因方面具有相当高的准确性。

APPLICATION OF 16 SLICE CT CHOLANGIOGRAPHY COMBINED WITH MULTIPLANAR REFORMATION IN PATIENTS WITH BILE DUCT OBSTRUCTION

[ Objective] To evaluate the diagnostic use of 16 slice CT cholangiography with multiplanar reformation (MPR) for the assessment of patients with biliary obstruction. [Methods] 16 slice CT cholangiography with the MPR technique was performed in 60 patients who were thought to have biliary obstruction. No cholangiographic contrast agent was administered. MRCP was used in 24 patients, endoscopic retrograde cholangiopancreatography (ERCP) in 16 patients. 28 patients underwent biopsy or surgery. The findings on 16 slice CT cholangiography were compared with those of MRCP, ERCP, biopsy or surgery. The surgery result was regarded as gold standard. [Results] The findings were as follows: choledocholithiasis (n = 34), ma- lignant stricture (n = 14), benign stricture (n = 2), and cholelithiasis (n = 12). A small common bile duct stone in one pa- tient could not be detected by 16 slice CT cholangiography. Two patients with initial diagnoses of small common bile duct stone by 16 slice CT cholangiography were disclosed to have malignant bile duct stricture by reference examination. The accuracy of 16 slice CT cholangiography for the diagnosis of bile duct stones was 91.1%.The accuracy of 16 slice CT cholangiography for the diagnosis of bile ductstricture was 87.5%. [Conclusion] 16 slice CT cholangiography with the MPR technique is a fast and non- invasive technique with relatively high accuracy for the diagnoses of the causes of biliary obstruction.