胆管结石34例的CT与B超诊断对比观察

Comparative study on CT and ultrasonography in the diagosis of calculus of bile duct of 34 cases

目的比较CT与B超对胆管结石的诊断价值。方法34例临床拟诊胆管结石患者行B超检查,其中23例同期行CT扫描,采用层厚和层距均为5mm进行常规扫描,对胆总管下端、胆囊颈部结石容易嵌顿部位,或高度怀疑者,先进行层厚和层距均为3mm薄层扫描,然后进行层厚为3mm和层距为1mm的重建。诊断均经手术证实,最后总结CT和B超诊断胆管结石的符合率。结果34例病人中,32例有胆管结石,2例手术中未见胆管结石。B超诊断结石31例,其中1例为假阳性,2例假阴性,诊断准确率为91%(31/34);CT诊断结石22例,假阴性1例,诊断准确率为96%(22/23)。结论CT是诊断胆管结石的有效手段,其诊断准确性优于B超,尤其是对有合并症者。

Objective To compare the value of CT and ultrasonography in the diagosis of calculus of bile duct. Methods Thlrty-four patients with calculus of bile duct diagnosed clinically underwent ultrasonography. A- mong them, 23 patients underwent routine CT scan with 5mm crept thickness and cmpt spinula. The calculus in infe- rior extremity of bile common duct and collum vesicae biliarista, or the extremely skeptic calculus, were scan by lamellar routine CT scan with 3mm cmpt thickness and cmpt spinula, then rebuilt with 3mm cmpt thickness and lmm cmpt spinula. All diagosis were confirmed by operation. Eventually, the diagnosis accuracy rate of CT and ultrasonography were summarized. Results Calculus of bile duct were confirmed by operation in 32 patients; calculus were not confirmed in 2 patients. Calculus were confirmed by uhrasonography in 31 patients; false positive was found in 1 patient, false negative in 2 patients, the diagnosis accuracy rate was 91% （31/34） ; calculus were confirmed by CT in 22 patients, fasle nogative in 1 patient,the diagnosis accuracy rate was 96% （22/23）. Conclusion CT was an effective mothod in diagnosing the calculus of bile duct, its diagnosis accuracy rate surpass uhrasonography, especially in the calculus patients with compliations.