64层螺旋CT、MRCP和ERCP在肝内胆管占位中的临床应用对比分析

目的探讨64层螺旋CT、MRCP和ERCP在肝内胆管占位中的临床诊断应用价值。方法52例均经B超检查提示有肝内胆管占位的患者,行64层螺旋CT增强扫描后,对原始数据采用多平面重建(MPR)及胆管三维容积重建(SCTC)处理,对胆管占位原因进行定位、定性诊断,其中有12例患者还进行了MRCP和ERCP检查,并与手术病理进行对照和随访观察。结果64层螺旋CT对肝内胆管占位病变定位及定性的准确率分别为100%及94%,MRCP和ERCP对肝内胆管占位病变定位及定性的准确率分别为100%、100%及78%、80%。结论64层螺旋CT具有强大的后处理功能,可无创、清晰、立体显示胆管结构,提高术前对疾病的定性、定位诊断率,对肝内胆管占位诊断有重要价值,并可进一步指导临床手术治疗,是一种很好的无创性检查方法,ERCP和MRCP对64层螺旋CT很难作出定性诊断的病例起到一个辅助诊断的方法。

The Comparative Analysis of Spiral CT, MRCP and ERCP about Its Clinical Application in the Intrahepatic Bile Duet Space Occupying Lesion

Objective To evaluate spiral CT,MRCP and ERCP about its application in the intrahepatic bile duct space occupying lesion and its value.Methods 52 cases with intrahepatic bile duct space occupying lesion diagnosed by B-ultrasonography were included.64 spiral CT enhancement scanning was carried out and all data were analyzed by MPR and SCTC in order to achieve the located and qualitative diagnosis of the reason resulting in bile duct space occupying lesion.Among them,12 cases had detection of MRCP and ERCP,and the results had comparative analysis with their pathology.All the cases were following up.Results 64 spial CT had accurate rate of 100%and 94% in located And qualitative diagnosis for intrahepatic bile duct space occupying lesion,while MRCP and ERCP are 100% vs 100% and 78% vs 80%.Conclusion slice spiral CT has a great post-processing functions,it can display bile duct structure with clear,volumetric and non-invasive and improve the located and qualitative diagnostic rate of the disease,and show its important value for intrahepatic bie duct space occupying lesion.This method also can furtherly instruct clinical treatment and is a better non-invasive detection method.ERCP and MRCP is auxiliary method for the cases that is hard to be diagnosed by spiral CT.