CT平扫与增强扫描对梗阻性黄疸的诊断价值

目的探讨CT对梗阻性黄疸的诊断价值。方法对38例经手术病理证实的梗阻性黄疸进行回顾性分析。其中，胆管癌9例，胰腺癌12例，胆总管结石16例，胆总管炎性狭窄1例。结果胆管癌中7例位于胆总管，2例位于肝门区胆管，均表现为梗阻上方胆管扩张。胰腺癌中8例表现为胰头增大，4例胰头增大不明显，增强扫描可见小结节状强化。胆总管结石中14例为阳性结石，表现为高密度影，2例为阴性结石，表现为低密度影。胆总管炎性狭窄1例，表现为肝内外胆管扩张，胆囊扩大，胆总管渐进性狭窄。结论CT除可以确定梗阻性黄疸的诊断以外，还能明确梗阻部位以及判断梗阻原因。

Diagnostic value of CT scanning without and with contrast enhancement for obstructive jaundice

Objective To evaluate the diagnostic value of CT scanning without and with contrast enhancement for obstructive jaundice. Methods CT findings of 38 patients with surgically and pathologically proved obstructive jaundice which comprised 9 cholangiocarcinomas, 12 pancreatic carcinoms, 16 choledocholithiases, and 1 choledochous inflammatory stenosis were analyzed retrospectively. Results Cholangiocarcinoma of 7 cases localized in choledochus, that of 2 cases localized in portal bile ducts, presenting as cholangiectasis above obstruction end. Pancreatic carcinoma of 8 cases presented as enlargement of pancreatic head, but that of 4 cases had no obvious enlargement of pancreatic head. After contrast enhancement, the carcinoid lesions presented as small nodular enhancement. Choledocholithiasis of 14 cases was positive lithiasis with hyperdensc shadow but that of 2 cases negative lithiasis with hypodense shadow. Choledochous inflammatory stenosis of one case presented as intrahepatic - and extrahepatic cholangiectasis, gallbladder enlargement and choledochous gradual stenosis. Conclusion CT can not only definitely diagnose the obstructive jaundice but can accurately identify the obstructive site and cause.