16层螺旋CT重建技术在胆管阻塞病人中的应用

The application of 16-slice CT cholangiography with MPR technique in biliary obstruction

目的:评价16层螺旋CT结合多平面重建(Multiplanar reformation,MPR)技术在胆管阻塞病人中的应用价值。方法:采用16层螺旋CT结合MPR技术对60例临床疑似胆管阻塞的患者进行诊断。其中24例行磁共振胰胆管造影成像(Magnetic resonance cholangiopancreatography,MRCP)检查,16例行逆行胰胆管造影(Endoscopic vetrograde cholangiography,ERCP)检查,28例行病理活检或外科手术。将16层螺旋CT检查结果与MRCP成像、ERCP、病理活检及外科手术结果进行对比。以手术病理结果为标准。结果:检查结果如下:胆总管结石34例,恶性狭窄14例,良性狭窄2例,胆石症12例。16层螺旋CT诊断胆管结石的准确率为91.1%。16层螺旋CT诊断胆管狭窄的准确率为88.9%。其中1例小胆总管结石未能检出,2例初诊为胆管结石的病人后经诊断为恶性胆管狭窄。结论:16层螺旋CT及多平面重建技术是一种快速、无创技术,在诊断胆管阻塞原因方面具有极高的准确性。

Objective：evaluate the diagnostic use of 16-slice CT cholangiography with multiplanar reformation（MPR）for the assessment of patients with biliary obstruction.Methods：16-slice CT cholangiography with the MPR technique was performed in 60 patients who were thought to have biliary obstruction.No cholangiographic contrast agent was administered.MRCP in 24 patients,Endoscopic retrograde cholangiopancreatography（ERCP）in 16 patients,and 28 patients underwent biopsy or surgery.The findings on 16-slice CT cholangiography were compared with those of MRCP,ERCP,biopsy or surgery.the surgical-pathological result was regarded as gold standard.Results：The findings were as follows：choledocholithiasi（sn=34）,malignant stricture（n=14）,benign stricture（n=2）,and cholelithiasi（sn=1）.A small common bile duct stone in one patient could not be detected by 16-slice CT cholangiography.Two patients with initial diagnoses of small common bile duct stone by 16-slice CT cholangiography were disclosed to have malignant bile ductstricture by reference examination.The accuracy of 16-slice CT cholangiography for the diagnoses of bile duct stones and bile duct stricture were 91.1% and 88.9% respectively.Conclusion：16-slice CT cholangiography with the MPR technique is a fast and non-invasive technique with relatively high accuracy for the diagnoses of the causes of biliary obstruction.