急性胆道穿孔的CT诊断(附15例分析)

CT diagnosis of acute biliary tract perforation (analysis in 15 cases)

目的 :分析CT在急性胆道穿孔诊断中的价值及诊断要点。方法 :对 15例病例均采用CT平扫加增强 ,层厚10mm、层距 10mm连续扫描 ,局部层厚、层距 5mm薄层扫描。结果 :15例中 14例显示胆囊或胆总管张力明显减低 ,胆囊、胆总管壁皱缩 ;胆囊壁增厚 12例、明显增厚 2例 ;1例表现为胆囊增大 ;15例均可见胆囊窝周围蜂窝织炎 2例。结论 :急性胆道穿孔临床体征与症状不典型 ,术前诊断较难 ,CT可根据胆道外型缩小、张力明显减低、壁皱缩 ,腹腔积液于胆道周围为主等典型征象 。

Objective:To evaluated the valu e of CT in the diagnosis of the acute biliary tract perforation.Methods:The plain and contrast CT scans were pe rformed in 15 cases,the scans thickness was 10mm and 5mm in range of interested.Results:14 cases showed the tension of the gall bladder or the common choledoch decreased obviously and the wall shrank.The thi ckness of gallbladder wall increased in 12 cases,and increased significantly in 2 cases.Gallbladder expanded in 1 case.The hydrops in fossa for gallbladder and ascites were observed in 15 cases.Peribiliary phlegmonous inflammation was dete cted in 2 cases.Conclusion:The clinical symptom s of the acute biliary tract perforation were not typical,and the preoperative diagnosis was difficult.Our study suggested that acute biliary tract perforatio n by diagnosed definitely by the c hanges in CT image.