16层螺旋CT阴性法胆管成像在肝外胆管梗阻中的应用

Application of negative 16-slices spiral CT cholangiography in extrahepatic bile duct obstruction

目的评价16层螺旋CT阴性法胆管造影(N-CTCP)及曲面成像(CPR)对肝外胆管梗阻性疾病的诊断价值。方法89例肝外胆管梗阻患者,使用血管对比剂行增强扫描,将扫描重建数据在工作站进行编辑处理,获得最小强度投影(MinIP)和CPR图像,根据最小强度投影(MinIP)及CPR图像对梗阻部位、性质诊断,并与手术病理结果对比。结果MinIP和CPR对判断肝外胆管梗阻的定位诊断准确率100.0%,定性诊断准确率分别为91.0%和95.5%。结论N-CTCP作为一种无创伤性检查方法,对肝外胆管梗阻部位识别的准确率高,N-CTCP及CPR图像结合,获得轴位原始像(ASI)能对胆管梗阻性质的判断有较高的准确性。

Objective To evaluate the value of negative 16 slices CT cholangiography （N-CTCP） and curved planar reformation（CPR） in diagnosing extrahepatic bile duct obstruction. Methods Eighty-nine patients with extrahepatic bile duct obstruction were undergone 16 slices spiral CT contrast scanning. The raw date of scanning were firstly reformatted to bring out axial source images and then minimum intensity projection（MinIP） and curved planar reformation（CPR） images were obtained by editing ASI on the workstation. The diagnosis of obstructive location and character based on MinIP and CPR images. The results were compared with surgical findings and pathology. Results The locating and qualitative accuracy of MinIP and CPR in extrehepatic bile duct obstructive disease were 100% and 91% ,respectively, the qualitative accuracy of CPR was 95.5%. Conclusion N-CTCP and CPR were noninvasive technique for the evaluation of obstructive bilary pathology.