64排螺旋CT重建技术与MRCP对胆道梗阻性疾病的诊断价值

目的:比较磁共振、CT两种影像手段诊断胆道梗阻性疾病的差异。方法:收集40例临床诊断为梗阻性黄疸的患者,行64排螺旋CT腹部扫描检查,同时行MRCP、MRI检查,所有病例均行手术或ERCP检查获得病理结果。利用多平面、曲面重建技术对所得CT增强图像进行胰胆管重建,与MRCP、MRI检查结果对比,并与手术病理结果对照。结果:MRI结合MRCP、CT定位诊断的准确率分别为95%(38/40)、82.5%(33/40);定性诊断的准确率分别为92.5%(37/40)、90%(36/40)。两种影像学在定位方面具有统计学差异(χ2=5.124,P<0.05),但在定性方面则不具有统计学差异(χ2=1.848,P>0.05)。结论:MRI结合MRCP判定疾病部位的准确率最高,CT则快速、方便,在临床上应结合不同的患者的实际情况进行不同的检查。如果二者结合判断梗阻性黄疸的病因十分精确。

Comparative study on diagnosis of obstruction of bile duct by cholangiopancreatic using reconstructure technology of 64-slice spiral CT and MRCP

Objective: To contrast the imaging methods of magnetic resonance with CT in diagnosis of bialiry tract obstructive disease.Methods:collecting 40 patients with jaundice obstructive,then scan them with 64 CT at abdomen.mean while,examination by MRCP.MRI,all the cases should have an operation or scanning by the ERCP to obtain more pathological results.Using multi planar reformations and curved planar reformatted image reconstruction technology rebuilt Pancreaticobiliary duct through the CT enhanced images,comparing with the results of MRCP and MRI,contrasting with operation pathological results.Results:the accuracy rate of position oriented diagnosis through MRI combining with MRCP and CT respectively is 95%(38/40)and 82.5%(33/40),the accuracy rate of etiologic diagnosis respectively is 92.5%(37/40) and 90%(36/40).There are some differences of statistics between two kinds of imaging study of position(χ2=5.124.p<0.05).but the statistics differences don’t exist in positioned aspects(χ2=1.848,p>0.05).Conclusion:the accuracy rate that combined with MRI and MRCP is the most precise,and CT scanning is very fast and convenience.different methods should apply to different situation that according to the patient’s health.The biliary tract obstructive disease will be diagnosed precisely if these two methods combined together.