MSCT的MinIP＋CPR技术在胆道梗阻中的应用价值

目的：探讨多层螺旋CT（MSCT）的最小密度投影（MinIP）联合曲面重建（CPR）即MinIP＋CPR技术在胆道梗阻中的应用价值。材料和方法：收集45例经临床证实的梗阻性黄疸患者，均于MSCT扫描后进行MinIP＋CPR胆道成像并进行分析。结果：良性病变25例，其中胆管结石12例、胆总管炎症5例、胆囊结石并胆管炎6例、胰腺炎2例；恶性病变20例，其中胆管癌10例、胆囊癌侵犯或转移累及胆管3例、胰头癌累及胆管4例、壶腹部癌3例。MinIP＋CPR对良、恶性病变的定位准确率分别为92.0％和95.0％，定性符合率分别为88.0％和90.0％。MinIP＋CPR图像不同程度纠正了轴位及多平面重建（MPR）图像作出的定位、定量或定性诊断，尤其提高了对恶性病变的诊断准确率（P<0.05）。结论：MSCT的MinIP＋CPR技术能更直观清晰地显示病变的范围和性质，是胆道梗阻病变尤其是恶性病变检查的有效手段。

The value of MinIP+CPR of MSCT in biliary obstruction

Objective： To evaluate the value of the minimum intensity projection（MinIP） and surface reconstruction（CPR） of multi-slice CT（MSCT） in biliary obstruction diseases.Materials and Methods： Forty-five patients with obstructive jaundice underwent MSCT scanning,and all the images were post processed with MinIP＋CPR technique and analyzed.Results： There were 25 patients with benign lesions,including 12 cases of bile duct stones,5 cases of common bile duct inflammation,6 cases of gallstones and cholangitis and 2 cases of pancreatitis,20 patients had malignant lesions,including 10 cases of cholangiocarcinoma,3 cases of gallbladder involving the bile duct,4 cases of pancreatic cancer involving the bile duct,3 cases of ampullary carcinoma.The accurary for the location of benign and malignant lesions by MinIP＋CPR were 92.0% and 95.0% respectively,and the qualitative coincidence rate was 88.0% and 90.0%.To some extent,images of MinIP＋CPR techniques corrected those of axial and multi-planar reconstruction（MPR） techniques for telling the location,quantity and nature of the lesions,which especially improved diagnostic accuracy（P0.05） of malignant lesions.Conclusion： MinIP＋CPR techniques of MSCT can show the location and the nature of the disease more clearly,which is an essential and effective screening method for biliary obstruction,especially for malignant biliary obstruction diseases.