多层螺旋CT阴性法胰胆管造影在肝外胆管梗阻诊断中的应用(附40例报告)

目的　评价多层螺旋CT(MSCT)阴性法胰胆管造影 (N -CTCP)对肝外胆管梗阻性疾病的诊断价值。方法　对 40例肝外胆管梗阻性疾病 (肝外胆管结石 19例 ,恶性胆管梗阻 2 1例 )进行N -CTCP成像 ,将扫描重建数据行编辑处理 ,获得最小强度投影(MinIP)图像 ,结合CT轴面源像 (ASI) ,并与临床诊断或手术病理结果对照。结果　 40例均 1次屏气完成扫描 ,N -CTCP成像显示胆管树满意 ,MinIP对判断肝外胆管梗阻和定位诊断准确率为 10 0 % ,定性诊断准确率为 85 %。结论　N -CTCP对肝外胆管梗阻定位准确 ,结合轴面源像 (ASI) ,对肝外胆管结石及恶性胆管梗阻的判断有较高的准确性。

The Application of Negative MSCT Cholangiopancreatography in Diagnosis of Extrahepative Biliary Obstructic Disease( A Report of 40 Cases )

Objective To evaluate the diagnostic value of extrahepatic bile duct obstructive disease by negtive CT cholangiopancreatography (N-CTCP) using multiple spiral CT (MSCT). Methods 40 patients with extahepatic bile duct obstructive disease (19 patients with extahepatic choledocholithiasis and 21 patients with malignant biliary obstruction) were examined by N-CTCP.The imaging data were reconstructed and processed to obtain the minimum intensity projection (MinIP) images.The MinIP images ,axle source image (ASI), clinical diagnosis and surgical pathology were analysed. Results All patients were examined successfully in holding breathonce. The locating accuracy of MinIP in extrehepatic bile duct obstructive disease was 100%, the qualitative accuracy was 85%. Conclusion N-CTCP can accurately define the obstructive site in extrahepatic biliary obstruction. The specificity for the diagnosis of extrahepatic choledocholithiasis and malignant biliary obstruction is very high when combining with ASI.