螺旋CT诊断恶性梗阻性黄疸的评估

The Diagnostic Value of Spiral CT in Malignant Obstructive Jaundice

目的 探讨螺旋ＣＴ对恶性梗阻性黄疸的诊断价值。方法 选取资料完整恶性梗阻性黄疸１７例，均经手术病理及临床证实。所有病例均作了螺旋ＣＴ平扫，螺距为１，扫描完毕后即作２－５ｍｍ薄层重建。其中９例作了造影增强扫描及５、１０、１５、２０、３０分钟后延迟平衡期扫描。结果 螺旋ＣＴ对各种恶性病变的ＣＴ征象，特别是扩张胆管的移行段各种形态，管腔内细小结节及Ｖａｔｅｒ壶腹部小肿块显示清楚，从而对各种恶性梗阻病变均能作出满意的定位及定性诊断。另外肝内胆管癌３例平扫与肝癌难于鉴别，但增强后延迟平衡期扫描出现特征性改变而确诊。全组正确率 ９４．２％。结论 螺旋 ＣＴ对恶性梗阻性黄疸有很高诊断价值，应作为首选检查方法。

Objective To evaluate the applicable value of spiral CT in diagnosing the cause of malignant obstructive Jaundice (MOJ) Methods The CT features in 17 patients with surgically and clinically proved MOJ were analyzed. After plain scanning(pitch 1 ), reconstruction pictures(2 - 5mm collimation) were performed. Enhanced spiral CT scanning was done in 9 patients, and CT pictures were obtained at 5' 10' 15' 20' 30' after enhancement. Results Spiral CT can clearly display shapes of dilatant bile duct, small nodules of lumen and small mass in ampulla of Vater. It is helpful for the locational and histological diagnosis of all kinds of malignant obstructive lesions. 3 cases of intrahepatic cancer of biliary duct were difficult to distinguish from hepatic carcinoma by CT plain scanning, which was confirmed by characteristic features in enhanced delay - equilibrium. The accurate rate of spiral CT in the study was 94. 2%. Conclusion Spiral CT has a higher diagnostic value for MOJ It should be served as the first select examination.