多层螺旋CT多层面重建技术在胆道梗阻性疾病诊断中的应用

Multislice CT multiplanner reconstruction in diagnosis of biliary tract obstructive diseases

目的评价多层螺旋CT(MSCT)多层面重建技术(MPR)在胆道梗阻性疾病中的诊断价值。方法201例经超声诊断为梗阻性黄疸的患者,行MSCT平扫及薄层增强扫描,并以MPR技术进行冠状位、矢状位及沿胆总管走行方向斜位重建,然后与超声及磁共振胰胆管成像(MRCP)进行对比,以手术病理结果为标准。结果定位诊断超声为89.05%,MSCT MPR及MRCP均为100%;病因诊断超声为80.1%,MSCT MPR为97.0%,MRCP为92.0%。结论MSCT MPR技术在胆道梗阻性疾病中定位诊断能力高于超声,与MRCP相同;病因诊断能力明显高于超声,略高于MRCP。MSCTMPR技术可以显示胆管腔内的肿物,结石等病变形态,显示与周围组织的关系。

Objective To evaluate multi slice CT （MSCT） muhiplanner reconstruction （MPR） technique in the diagnosis of biliary tract obstruction diseases. Methods Two hundred and one patients who were diagnosed as obstructive jaundice by ultrasound examination were included in this study. Both MSCT common scan and contrast thin slice scans were used to acquire images, and MPR technique was used to reconstruct the images along coronary, sagittal and the direction of common biliary tract distribution. The value of MSCT MPR on both localizing and qualitative diagnosis of biliary tract obstruction was evaluated by comparing the reconstructed images with ultrasound studies and MRCP while the surgery result was regar ded as gold standard. Results The accuracy of ultrasound on localizing diagnosis was 89. 05%, while MSCT MPR and MRCP were both 100%. The accuracy of qualitative diagnosis were 80. 1%, 97.0% and 92% respectively. Conclusion MSCT MPR is better than uhrasound but equal to MRCP on localizing diagnosis of biliary tract obstruction. On qualitative diagnosis ability, MSCT MPR is obviously higher than uhrasound, while only a little higher than MRCP. Using MSCT MPR, we can observe the changes of morphology such as neoplasia or stone, as well as the relationship with surroundings.