薄块最小强度投影多层螺旋CT胆管造影评价胆管梗阻疾病

The Evaluation of Multislice CT Cholangiography Using Thin Slab Minimum Intensity Projection in Patients with Biliary Obstructive Diseases

目的评价薄块最小强度投影（thin-slab MinIP）多层螺旋CT胆管造影对胆管梗阻疾病的诊断价值。．资料与方法42例经临床确诊的胆管梗阻患者均行多层螺旋CT双期增强扫描。门脉期重建图像应用三维后处理软件．通过对移动剪辑（SC）、转动剪辑（RC）和投影块厚度（ST）的调节．以thin—slab MinIP方式显示梗阻胆系。对照手术病理结果，以直接胆管造影（34例）和磁共振胰胆管造影（MRCP）（8例）为参考标准，thin—slab MinIP像与之就疾病定位、定性诊断作出比较。结果42例中，thin—slab MinIP像平均成像时间4．5min；ST所取范围5～30mm。对照手术病理结果，thin—slab MinIP像定位、定性准确度分别为97．6％（41／42）、85．7％（36／42）；参考标准分别为100．0％（42／42）、90．5％（38／42），两种方法比较差异无统计学意义（Y0值分别为0．00、0．10，P值均〉0．05）。其中thin—slab MinIP诊断胆管结石的敏感度为84．2％（16／19），特异度为91．3％（21／23），准确度为88．1％（37／42）。结论thin—slab MinIP多层螺旋CT胆管造影成像快捷，可作为诊断胆管梗阻疾病的一种有效补充方式。

Objective To evaluate the value of muhislice CT cholangiography using thin slab minimum intensity projection （ thin slab MinIP） in biliary obstructive diseases. Materials and Methods 42 patients with biliary obstructive diseases proved by clinic were performed muhislice helical dual phase CT scan. CT cholangiography was reconstructed using thin slab MinIP by adjusting the shift clip （SC）, rotate clip （RC）, and thickness slab （TS）. Thin slab MinIP images were then compared to the reference standard of direct cholangiography （36 patients） and MR cholangiopancreatography （MRCP） （8 patients） in defining location and qualitative diagnosis. Results The imaging time of thin slab MinIP was 4.5 min on average and the ST ranged from 5 to 30 mm, its accuracy in diagnosis of the level and cause was 97.6% （41/42）, 85.7% （36/42） and the reference standard was 100.0 % （42/42）, 90.5 % （38/42） , respectively, compared to the surgical and pathologic results. There was no significant difference between thin slab MinIP and the reference standard （ X^2 = 0.00, 0.10. P 〉 0.05） . Meanwhile, the sensitivity, specificity. and accuracy of thin slab MinIP in diagnosis of bile duct stones were 84,2% （16/19） , 91.3% （21/23）. and 88.1% （37/ 42）, respectively. Conclusion Muhislice CT cholangiography using thin slab MinIP is a fast imaging technique and can be con- sidered an effectively complimentary modality for the diagnosis of the patients with biliary obstruction.