饮水低张MSCT技术在胆管梗阻性疾病中的应用

目的探讨饮水低张MSCT技术在胆管梗阻疾病中的应用价值。方法对76例临床拟诊梗阻性黄疸患者行饮水低张MSCT扫描,分析其CT表现,与病理结果对照。结果定位准确率最高的为第3段胆管;良性胆道病变定性准确率最高的是胆管结石,恶性胆道病变定性准确率较高的是壶腹周围癌及肝外胆管细胞癌;胆管扩张CT表现为渐进性扩张24例,其中良性病变17例,恶性7例;节段性扩张12例,其中良性扩张7例,恶性5例;软藤样扩张38例,其中良性扩张1例,恶性扩张37例。杯口样狭窄25例,鸟嘴样狭窄16例,均为恶性病变;靶征出现7例,均为胆总管结石。25例壶腹周围癌中,半月征出现7例,双环征8例,双管征12例,指样征9例。结论采用饮水低张MSCT技术,良、恶性胆管梗阻性疾病在CT表现上具有一定特征,结合综合征象,能提高螺旋CT在胆管梗阻性疾病的定位、定性准确率。

Diagnosis of biliary tract obstructive diseases by multislice CT after low tension and drinking water

Objective To explore the value of the multi-slice CT(MSCT) after low tension and drinking water in the diagnosis of biliary tract obstructive diseases.Methods Seventy six patients planning to be diagnosed as obstructive jaundice clinically were examined by multi-slice CT after low tension and drinking water,and their pathologic results were analyzed and compared.Results The third period of bile duct was positioned with the highest accuracy;bile duct stones were found with the highest qualitative accuracy in benign biliary obstruction;vater ampulla carcinoma and extrahepatic bile duct carcinoma were found with the higher qualitative accuracy in malignant biliary obstruction;there was "progressive expansion" in 24 cases,17 cases of which were benign lesion and 7 cases of which were malignant lesion;there was "segmental expansion" in 12 cases,7 cases of which were benign lesion and 5 cases of which were malignant lesion;there was "soft rattan" in 38 cases,1 case of which was benign lesion and 37cases of which were malignant lesion;there were 25 cases of "edge sample" narrow and 16 cases of "beak kind" narrow,which were malignant lesion;7 cases of "target sign" were choledocholithiasis;there were 25 cases of vater ampulla carcinom,7 cases of which had "half levy",8 cases of which had "double loop levy",12 cases of which had "double duct",and 12 cases of which had "finger sign".Conclusion By means of multi-slice CT after low tension and drinking water,there were some characteristics in benign and malignant biliary tract obstructive diseases in CT performance,and thus MSCT positioning accuracy and qualitative accuracy can be improved by combining the various signs.