胆管结石的CT诊断

CT Diagnosis of the Biliary Duct Stone

作者收集经手术证实的胆管结石39例,对其CT征象和诊断进行了分析。大多数患者具有上腹痛、发热和黄疸。全部病例行CT检查,部分病例行B超、ERCP和PTC。CT的直接征象:肝内胆管结石表现为高密度影或软组织密度影(20/23);肝外胆管结石表现为靶征或胰头高密度影(14/24)。间接征象表现为肝内胆管扩张,肝外胆管结石还表现为胆总管扩张。下端逐渐变细。作者认为胆管结石的CT诊断应依据直接征象,参考间接征象,综合提出诊断。本文还对胆管结石的影象诊断方法进行了讨论。

The CT findings and diagnosis of 39 operatively verified cases of bile duct stone are analysed. All the cases are studied with CT,part of the cases are studied with ultrasonography, ERCP and PTC. The direct CT findings, the intrahepatic biliary duct stones display high attenuation shadow or soft tissue density (20/23); the extrahepatic biliary duct stones display target sign or high attenuation shadow in the pancreatic head (14/24). The indirect findings show the dilatation of the intrahepatic biliary system.The extrahepatic biliary duct stone also shows dilatation of the distal common bile duct (CBD) with gradually fining away. CT diagnosis of the bile duct stone is considered to base on the direct findings with reference of the indirect findings and synthesized diagnosis.The thin slice scanning technology can press the visible rate of the CBD stone (it should be a routine studying method of the CBD stone). The method of imaging diagnosis of the biliary duct stone is also discussed.