胆胰十二指肠结合部多层螺旋CT仿真内镜技术临床应用

Clinical application of MSCT virtual endoscopy in biliary pancreatic junction

目的 探讨多层螺旋CT仿真内镜技术（CTVE）在胆胰十二指肠结合部病变检测方面的临床应用价值.方法 健康志愿者30例,胆总管结石18例,壶腹癌7例,行多层螺旋CT扫描并进行CTVE重建,观察十二指肠乳头形态并测量其大小.结果 CTVE重建图像显示十二指肠乳头健康志愿者呈结节型16例、＂V＂型8例、＂Y＂型6例,直径为（0.84土0.17）cm,胆总管结石患者呈结节型,其直径为（1.72±0.32）cm,壶腹癌患者呈不规则隆起型,其直径为（2.30±0.85）cm,总体均数之间差异有统计学意义（P＜0.01）.结论 利用CTVE可以观察十二指肠乳头形态并测量其大小,为十二指肠乳头及其周围病变的检测提供了一种方便、无创伤、准确的临床检查方法.

Objective To determine the clinical value of the multi-slice spiral CT virtual endoscopy （CTVE） for the detection of biliary pancreatic junction lesions. Method MSCT and virtual endoscopic reconstruction were performed in 30 healthy volunteers, 18 cases of common bile duct stones and 7 cases of ampullary carcinoma to observe patterns of duodenal papilla and measure its size.Results Reconstructed image of CTVE showed that the normal duodenal papilla was nodular in 16,shaped like ＂V＂ in 8 ＂Y-shaped＂ in 6 of the healthy volunteers. Its diameter was （0.84±0.17）cm. In the patients with common bile duct stones, it was nodular and its diameter （1.72±0.32）cm. In the patients with ampullary cancer, it was of irregular protruded type and its diameter （2.30±0.85）cm.There was significant difference among the 3 groups in the overall mean values （P〈0.01）. Conclusion CTVE is a convenient, non-invasive and precise clinical examination to observe the shape of duodenal papilla and determine its size.