128层螺旋CT动态容积扫描对肝门部胆管癌的诊断价值

目的探讨128层螺旋CT动态容积扫描对肝门部胆管癌的诊断价值及其对临床治疗方法的指导意义。方法对12例确诊的肝门部胆管癌患者的128层CT影像资料进行综合分析,成像方法包括动态容积扫描及CT工作站的多平面重组(MPR)、最大密度投影(MIP)、曲面重组(CPR)及容积再现(VR)等后处理技术。结果 12例患者均有不同程度肝内胆管树枝状扩张。6例(35.99%)表现为管壁浸润型:4例(33.33%)表现为结节肿块型;2例(16.67%)表现为乳头状型。利用EBW工作站后处理技术清楚显示了肝门部胆管癌病变本身情况及临近结构受累及情况,胆管造影下的CT三维重建技术完整显示了胆管树及左、右肝管受侵狭窄情况。结论128层螺旋CT动态容积扫描对于显示肝门部胆管癌肿块的部位、大小、密度、局部扩散、血管有无受侵犯、淋巴结及邻近器官是否受累、有无远处转移、胆管扩张程度及有无腹水等方面有着独到的优势。128层螺旋CT对肝门部胆管癌全面的影像学观察与分型,对估计预后及临床治疗方法、方式的选择具有重要的指导意义。

The Value of 128 Slice Spiral CT Dynamic Volume Scanning in Diagnosis of Hilar Cholangiocarcinoma

Objective To study the value of 128 slice spiral CT dynamic volume scanning in diagnosis of hilar cholangiocarcinoma and its guiding significance to the clinical treatment method. Methods 128 slice CT imaging data of the patients with hilar cholangiocarcinoma in 12 cases were analyzed, hnaging methods including dynamic volume scanning and CT workstation postprocessing technique such as MPR,MIP,CPR,VR,etc. Results 12 patients had different degree of intrahepatic bile duct dendritic expansion, 6 cases （35.99%） showed Bile duct wall infiltration; 4 cases （33.33%） showed nodular mass; 2 cases （16.67%） showed papillary type; Using EBW workstation postprocessing technique clearly shows the hilar cholangiocarcinoma lesion itself and adjacent structure involvement,with 3D reconstruction technique of CT to complete display the biliary tree and left, right hepatic duct the stenosis situation after cholangiography. Conclusion The 128 slice spiral CT dynamic volume scanning has a unique advantage for the display of hilar cholangiocarcinoma tumor location,size,density,local diffnsion,blood vessels have no invasion,lymph node and adjacent organ involvement,whether metastasis,bile duct dilatation degree and whether the ascites etc.The 128 slice spiral CT on hilar cholangiocarcinoma comprehensive imaging observation and classification, has an important guiding significance for estimating the prognosis and clinical selection of appropriate treatment and method.