单排螺旋CT增强扫描对肝外胆管胰腺段活体形态学观察

In vivo morphological investigation: imaging manifestations of the common bile duct in pancreas with enhanced spiral CT scan

目的 利用单排螺旋CT增强扫描技术对肝外胆管胰腺段进行活体形态学观察。方法 顺贯抽取 2 41例上腹部单排螺旋CT增强的病例 ,男性 172例 ,女性 69例 ,年龄 16～ 81岁 ,对住院病例 (3 3例 )追踪术后病理结果。按病种分为 4组 ,分别观察肝外胆管的形态、大小、肝外胆管胰上段、胰头段及钩突段位置、长度。结果 正常及无胆胰疾病的人肝外胆管普通CT显示率较低 ,增强扫描后显示率明显提高。随年龄增加 ,显示率亦增加。肝外胆管胰腺段的形态多呈圆形 ,钩突段变扁 ,大多位于门静脉的右前方 ,长度 8～ 3 2mm(平均 11 9mm) ,管径 1～ 4mm(平均 1 6mm)。胆胰疾病组病人管径 5mm以上者占 5 0 %以上。结论 活体肝外胆管胰腺段正常值的上限应定为 4mm。

Objective To observe the in vivo morphological structures of the common bile duct in pancreas on the images of enhanced spiral CT scan. Methods We chose 241 consecutive patients undergoing enhanced spiral CT scan of the abdomen (male: 172, female: 69, age range: 16-81). The pathological results of 33 patients hospitalized were recorded. All 241 patients were divided into 4 groups according to the various kinds of diseases. The shape and size of the common bile duct, the superior segment of the extrahepatic bile duct, the location and length of the head of pancreas and uncinate process of pancreas were observed. Results The common bile duct of normal subjects and patients free from diseases in the pancreas and the bile duct could not be easily observed with common spiral CT, but enhanced spiral CT scan could increase the displaying rate in an age-dependent manner. The shape of the common bile duct in pancreas was round and turned into ellipse or line in the uncinate process of the pancreas. The common bile duct was always at the top right corner of vena cava and its length and diameter were 8-32 mm (average: 11.9 mm) and 1-4 mm (average: 1.6 mm), respectively. The diameter of the common bile duct larger than 5 mm was found in 50% patients in the group of pancreas and bile duct diseases. Conclusion The upper limit of the normal diameter of the common bile duct in the pancreas should be 4 mm.