MSCT对胆总管下段阴性结石的诊断价值

Application and significance of multislice spiral CT for diagnosing the negative stones in the lower end of the choledochus

目的探讨多层螺旋CT在诊断胆总管下段阴性结石方面的应用及意义。方法31例胆总管下段阴性结石患者均经多层螺旋CT平扫及增强扫描,全部患者的胆总管下段阴性结石均经ERCP、EST或手术证实。结果CT平扫与增强扫描清晰显示胆总管下段阴性结石的部位、形态、大小和受累胆管的形态与扩长程度,以及胆总管结石伴发的炎症性改变。多层螺旋CT诊断胆总管下端阴性结石定位准确率达100%,定性准确率达87%。结论多层螺旋CT平扫及增强扫描检查在诊断胆总管下段阴性结石方面有较高的诊断价值,值得推广应用。

Objective To explore the application and significance of muhislice spiral CT （MSCT） for diagnosing the negative stones in lower end of the choledochus. Methods Thirty-one patients with negative stones in choledochal lower eml confirmed by endoscopie retrograde cholangiopancreatography（ERCP） or endoscopic sphincterotomy（EST） underwent without and with contrast enhanced CT scans of the abdomen. All patients whose CT findings were analyzed retrospectively. Results Unenhanced and contrast enhanced CT scans clearly showed the location, shape and size of the negative stones, the shape and dilated degrees of the affected bile ducts, and the inflammatory changes associated with choledocholithiasis. The localized and qualitative accuracy of MSCT in detecting the negative stones in choledochal lower end was 100 % and 87 %, respectively. Conclusion Unenhanced and contrast enhanced scans with MSCT have important value in the diagnosis of the negative stones in choledoehal lower end and it is worth wide adoption.