CT对壶腹旁憩室综合征诊断价值的探讨

Application of CT in the diagnosis of periampullary diverticula syndrome

目的探讨壶腹旁憩室综合征(Periampullary diverticula syndrome,PADS)的CT表现、诊断价值及分型。方法回顾性分析经内镜或手术证实的22例PADS患者的CT表现,所有患者均行螺旋CT扫描,并提出本病的CT分型。结果22例患者中,共22个憩室。表现为十二指肠降段内侧囊状含气影者13例,含气液平面7例,表现为液性囊状影2例。合并胆管结石11例(其中4例合并胆囊结石),胆囊结石5例,仅表现为肝外胆管轻度扩张4例,胆源性胰腺炎1例,胆管细胞癌1例。结论CT能清楚显示憩室及其胆胰系统并发症,是诊断PADS有效的影像检查方法。

Objective To evaluate the CT manifestations and diagnostic value in periampullary diverticula syndrome（PADS）. Methods CT manifestations of 22 patients with PADS were retrospectively analyzed. All patients were proved by endoscopy or surgical operation. Abdomen CT scans were performed in all patients and divided into three types. Results Cysts licating at the inner wall of the descending part of duodenum were found in 22 patients, in which air, air - liquid and fluid were seen in 13, 7 and 2 patients. In the 22 ptients, 1 lcomplicated with cholelithiasis （50%）, 5 complicated with cholecystolithiasis（23% ）, 4 complicated with extra - hepatic cholangiectasis （biliary ductdiameter 〉 1.0 cm）（ 18% ）, 1 with biliary pancreatitis （5%）, 1 with cholongiocarcinoma （5%）. Conclusion PAD and its pancreaticobiliary symptoms could be demonstrated clearly on CT so that CT is a simple, noninvasive and effective method.