胆总管下段梗阻44例影像学检查鉴别诊断体会

目的 总结影像学检查对胆总管下段梗阻的鉴别诊断经验.方法 选取胆总管下段梗阻住院患者44例作为研究对象,其中A组25例,为壶腹癌及胆总管下段癌患者;B组19例,为胆总管结石患者.统计两组患者的年龄、性别、首发症状和腹部B超、腹部CT、核磁共振（MRCP）、内镜逆行胰胆管造影（ERCP）测量的胆总管宽度及其对病变的诊断情况.结果 A组患者胆总管扩张程度高于B组,两组比较差异有显著性.对于胆总管结石的患者,除CT检查和B超与CT联合检查诊断率高于单用B超检查外,MRCP对胆总管下段结石的诊断率较高.结论 胆总管下段恶性梗阻患者的胆总管扩张程度高于胆总管结石,MRCP作为一种无创检查,在胆总管结石的诊断上具有较大优势.

The experience in diagnosis the lower obtruction of common bile duct

Objectsive To summarize the differentiate diagnose experience in the patients with lower obstruction of common bile duct. Methods We recruited 44 patients with lower obstruction of common bile duct,including group A involved 25 patients with malignant obstruction and group B involved 19 patients with choledocholithiasis. Ages, gender and initial symptoms were investigated, the dilated grade of common bile duct and the diagnosis of the disease were determined by image techniques. Results The dilated grade of common bile duct in group A was larger than group B ,The difference was significant between this two groups. The diagnosed ratio of MRCP was higher than CT scan or sonography, in choledocholithiasis patients. Conclusion The dilated grade of bile duct in malignant obstruction patients is larger than those in choledocholithiasis patients. MRCP has advantage in the diagnosis of choledocholithiasis.