结合EPCP与螺旋CT三维成像对阻塞性黄疸的诊断价值

目的：探讨对阻塞性黄疸更精确的影像学诊断方法。方法：对４５名怀疑有阻塞性黄疸的病人，行常规ＥＲＣＰ检查，退镜后立即进行螺旋ＣＴ扫描。将螺旋ＣＴ三维成像显示胆管阻塞的原因、位置和程度与ＥＲＣＰ的检查结果相比较。结果：４５名病人中，螺旋ＣＴ胆管造影显示了３０名病人有胆管阻塞，没有假阳性或假阴性病例。胆管阻塞的原因有：胆管结石２４例、胆管癌３例、胆管狭窄３例。ＥＲＣＰ与螺旋ＣＴ胆管造影均能对２４例胆管结

Diagnosis of Cholangetic Jaundice by Combined ERCP and Three-dimensional Spiral CT Cholangiography

Purpose: To investigate more precise method of iconography to diagnose cholangetic jaundice. Methods: After endoscopic retrograde cholangiography (ERCP), 45 patients with suspected cholangetic jaundice underwent upper abdominal spiral CT with subsequent three dimensional redering of the biliary tract. The reason, site and extent of biliary obstruction were compared with that at ERCP. Results: Spiral CT cholangiography correctly depicted biliary obstruction in 30 of 45 patients,with no false positive of false negative case. The reason of biliary obstruction: bile duct stone 24 cases, cholangiocarcinoma 3 cases, bile duct stenosis 3 cases. In 24 patients, the site and size of bile duct stone could be assessed with spiral CT cholangiography and ERCP. In two patients with cholangiocarcinoma, spiral CT cholangiography depicted undrained areas not seen with ERCP. In one patients, ERCP give the more precise diagnosis of intrahepatic bile duct stenosis. Conclusion: Combined ERCP and spiral CT cholangiography allow accurate assessment of the biliary system in patients with suspected cholangetic jaundice.