十二指肠乳头旁憩室致梗阻性黄疸的影像学诊断价值

The imaging value on diagnosis of obstructive jaundice due to duodenal diverticulum biside papilla

目的:探讨十二指肠乳头旁憩室(PAD)致梗阻性黄疸的CT或MRI表现。方法:分析18例PAD伴梗阻性黄疸的CT或MRI表现,所有病例均经手术、上消化道钡餐检查或胃镜检查确诊。结果:本组18例中,憩室直径小于2 cm的11例,大于2 cm的7例。PAD的CT和MRI表现为胰头右后方与十二指肠之间圆形或半圆形含气囊袋影,可见液气平面,部分憩室内可见食物残渣影。18例PAD均伴有胆道系统不同程度的梗阻扩张。增强扫描憩室壁及相邻十二指肠局部肠壁明显强化。结论:CT和MRI对PAD致梗阻性黄疸有十分重要的诊断价值。

Objective： To investigate the value of CT and MRI in diagnosis of periampullay duodenal diverticulum complicated with obstructive jaundice. Methods： CT or MRI manifestation of 18 patients with periampullay duodenal diverticula complicated with obstructive jaundice were retrospectively analyzed, all cases were confirmed by surgery, upper gastrointestinal barium meal examination or gastroscopy. Results： In 18 cases, the aged ranged from 62 to 93 years（mean 74 years）. 11 cases were less than 2 cm in periampullay diverticulum diameter, 7 cases were more than 2 cm. CT and MRI appeared between pancreatic head and duodenum as circular or semicircular in shape with gaseous density, which had a air-fliud level. 18 cases of periampullay duodenal diverticula were associated with different degrees of obstruction of biliary system expansion. Enhanced scan periampullay duodenal diverticulum and adjacent local intestinal wall was strengthened. Conclusion： CT and MRI should be beneficial to the diagnosis of periampullay duodenal diverticulum complicated with obstructive jaundice.