64层容积CT后处理技术在诊断肝外胆管癌中的应用

Application of 64-slice volume CT post-processing techniques in diagnosis of extrahepatic cholangiocarcinoma

目的探讨64层VCT后处理技术在肝外胆管癌(ECC)诊断中的应用。方法回顾性分析经手术(或活检)病理证实的ECC患者45例,均接受64层VCT平扫和三期增强扫描,并经MPR和CPR后处理,32例接受仿真内镜(CTVE)和MinIP。结果 45例中,上段胆管癌(HCC)20例,其中Ⅰ型4例,Ⅱ型4例,Ⅲ型6例,Ⅳ型6例;中段胆管癌(MCC)8例;下段胆管癌(DCC)17例。病变多呈轻、中度延迟强化。MPR和CPR图像均成功得到,部分MCC和DCC病例得到较满意的CTVE(17/25,68.00%)和MinIP图像(20/25,80.00%)。结合轴位图像,全部肿瘤位置及范围得到直观显示并准确诊断。结论应用各种64层VCT后处理技术(MPR、CPR、CTVE和MinIP)能够显示ECC的各种直接和间接征象,做出准确诊断。

Objective To explore the application of VCT post-processing techniques in the diagnosis of extrahepatic cholangiocarcinoma（ECC）.Methods Totally 45 patients with pathologically confirmed ECC who underwent 64-slice VCT plain scanning and triple-phase enhanced scaning were analyzed retrospectively.MPR and CPR were made in all cases,CT virtual endoscopy（CTVE） and MinIP were made in 32 cases.Results There were 20 patients with hilar cholangiocarcinoma（HCC）（Ⅰtype in 4,Ⅱ type in 4,Ⅲ type in 6,Ⅳ type in 6）,8 with middle extrahepatic cholangiocarcinoma（MCC）,and 17 with distal extrahepatic cholangiocarcinoma（DCC）.Slight or moderate delayed enhancement was showed in the lesions.MPR and CPR were made in all cases successfully,CTVE（17/25,68.00%） and MinIP（20/25,80.00%） images were obtained in some MCC and DCCs.The location and range of tumors were displayed using post-processing techniques combined with axial images.All cases were accurately diagnosed.Conclusion The direct and indirect signs of ECC could be displayed with 64-slice VCT post-processing techniques（MPR,CPR,CTVE and MinIP）,and accurate diagnosis be made.