螺旋CT胆道立体成像对胆道梗阻性疾病诊断价值的研究

目的 评价螺旋CT胆道立体成像对胆道梗阻性疾病的诊断价值。材料与方法 静脉注射胆道对比剂Biliscopin，对胆道不显影者给予血管对比剂。83例胆道梗阻性疾病患者均行上腹部螺旋CT容积扫描，在工作站利用软件将图像处理后得到胆道系统立体图像。结果 50例胆道显影者中，以胆管结石、炎症和胰腺炎致胆道梗阻多见，占48例；33例胆道不显影者中，以胆管癌、胰头或壶腹癌多见，占23例。螺旋CT胆道立体成像可以很好显示梗阻部位以上胆管扩张的程度和形态，可准确确定梗阻部位以及梗阻的原因，区别肿瘤、结石或炎症等。结论 螺旋CT胆道立体成像作为一种准确而无创伤性的检查方法，对胆道梗阻性疾病的诊断具有重要意义。

The Value of Spiral CT Three-dimensional Reconstruction in the Diagnosis of Obstructive Biliary Diseases

Objective To evaluate spiral CT 3 D reconstruction in the diagnosis of obstructive biliary diseases.Materials and Methods After infusing Biliscopin or angiographic contrast (for patients with non visualized biliary tract), upper abdominal spiral CT volumetric scanning with single breath-hold technique was performed in 83 patients with obstructive biliary disease. 3-D images of the bile ducts were obtained by using relevant software and workstation.Results Of 50 cases with visualized biliary ducts, 48 showed bile ducts obstruction due to biliary calculus, inflammation or pancreatitis. Of 33 cases with non visualized biliary ducts, 23 had cancers of biliary duct, pancreatic head or Vater's ampulla. Spiral CT 3 D reconstruction could well display the dilated ducts proximal to the obstruction site, could correctly show the cause and location of the obstruction and could help distinguish cancer from calculus and inflammation.Conclusion Spiral CT 3 D reconstruction of biliary ducts is a noninvasive and valuable technique, which is of great significance in the diagnosis of obstructive biliary diseases.