CT与逆行胰胆管造影诊断低位梗阻性黄疸对照分析

目的：通过分析低位梗阻性黄疸的CT和逆行胰胆管造影（ERCP）表现，以提高对该病的诊断准确率。方法：回顾性分析了经手术、病理或随访证实的梗阻性黄疸病例的CT（16例）及ERCP（28例）表现。结果：良性梗阻一般表现为胆总管扩张较轻，肝内胆管呈枯枝状，胆总管由上而下逐渐变细，CT上显示为胆总管下端等或高密度结石影，ERCP表现为胆总管下端充缺；恶性者则一般表现为胆管中-重度扩张，肝内胆管呈软藤状扩张，CT显示为扩张的胆管由上而下突然狭窄、巾断，ERCP则显示为胆总管下端偏心性、向心性狭窄或截断状改变。结论：CT和ERCP均能对梗阻性黄疽作出较准确的定位及定性诊断，而两者联合运用，能提高术前诊断准确率。

Compare Study of CT Diagnosis and ERCP in Low-level Obstructive Jaundice

Objective: To improve the diagnosis accuracy rate of low-level obstructive jaundice by comparing CT manifestation and endoscopic retrograde cholangiopanceatography(ERCP). Methods: We retrospectively analysised 16 cases of CT and 28 cases of ERCP of obstructive jaundice confirmed by surgery,pathology and followed-up study. Results: Benign obstructions always appear as slightly dialated common bile duct,intrahepatic bile duct as deadwood,common bile duct tapered from up to down.CT could show equal or hyperdensity stones in the low common bile duct,while ERCP could reveal filling-defect.Malignant obstructive jaundices often appear moderate-severe dialated bile duct,intrahepatic bile duct like soft-rattan.CT could show abrupt stenosis,break of the dialated duct,while ERCP could reveal eccenter stricture or broken change of duct. Conclusion: Both CT and ERCP can make accurate location or qualitative diagnosis of obstructive jaundice.We may improve the diagnosis accuracy rate by combining them two methods.