引流管胆道造影后多层CT检查胆道重建技术的临床应用

Evaluation of the image reconstruction technique after multislice CT cholangiography through bile duct drainage-tube

目的探讨多层CT胆道造影(MSCTC)在梗阻性黄疸患者术前综合评价中的应用价值。方法20例梗阻性黄疸患者术前进行了经皮肝胆管造影(PTC)或内窥镜逆行胰胆管造影(ERCP)置管,全部病例实施了MSCTC扫描,对图像进行了多平面重建(MPR)、容积再现(VR)、最大密度投影(MIP)及血管探针技术(VP)处理,判断胆道情况并与术中术后结果进行对照。结果20例患者中,MPR病因诊断准确率为100%。对于胆道一级分支受累的胆管癌患者VR、MIP、VP均能准确判断。VR、MIP、VP对于肝内外胆管结石患者诊断基本正确。胰头肿物以及胆管狭窄患者术前MSCTC后处理技术均能得到较完美的胆树成像。结论MSCTC可作为术前全面评价梗阻性黄疸患者的一种可靠检查方法。

Objective To evaluate the value of muhislice CT cholangiography （MSCTC） through drainage-tube in patients with bile duct obstruction pre-operation. Methods Twenty cases with bile duct obstruction were put drainage-tube in bile duct by PTC or ERCP. All these cases were undergone MSCTC scanning examination pre-operation. Multi-planar reformation （MPR）, volume rendering （VR）, maximum intensity projection （MIP） and CT vessel probe （VP） reformation were performed to observe liver and bile duct. To compared these images manifestation with those findings during or post-operation. Results Among these 20 patients, 100% etilogical diagnosis could be made in MPR. VR, MIP and VP could make correct diagnosis in the cholangiocrcinoma cases whose tumor had invaded grade one bile duct branch. VR, MIP and VP could make correct diagnosis in bile dute stone. Perfect bile duct 3D reconstruction results could be obtained in 4 cases of pancreatic head tumor and 2 cases of common bile duct stenosis. Conclusion MSCTC can be used as a new important examination in evaluating the bile duct obstruction in patients preoperatively.