评估MSCT双期增强扫描对中下段胆管癌诊断的价值

The Evaluation of the Dual-phase Contrastenhanced MSCT Scan in the Diagnosis of the Distal and Middle Cholangiocarcinoma

目的评估MSCT双期增强扫描对中下段胆管癌诊断的价值。方法回顾性分析15例经手术病理证实的胆管中下段癌的CT增强表现。多层CT采用薄层双期(动脉和门脉)增强扫描,双期扫描均采用层厚和间隔均为3-5mm的薄层采集,10例行多平面重建观察。结果动脉和门脉期增强扫描,13例显示胆管管壁增厚,2例显示胆管腔内结节影,动脉期轻中度强化,门脉期中度以上强化。所有病例均可见梗阻段以上胆管扩张、肝内胆管扩张,胆囊增大。MPR图像有助于显示病灶全貌。结论 MSCT双期增强扫描及MPR图像对中下段胆管癌定性诊断具有很高价值。

Objective To evaluate the value of the dual-phase contrast-enhanced MSCT scan in diagnosing the distal and middle cholangiocarcinoma.Methods A retrospective MSCT enhancement findings was analyzed in 15 cases of the distal and middle cholangiocarcinoma which were proved of pathological examination after operations.MSCT by the thin-slice dual-phase（arterial and portal phase） contrast-enhanced technology was used in all cases.For the dual-phase contrast-enhanced scan,the thin-slice requisition with 3-5mm thickness and interval was used,multiplanar reconstruction（MPR） was performed in 10 cases for the further observation.Results For the thin-slice dual-phase MSCT scan,the wall thickening and intra-luminal nodule of involved bile ducts were respectively shown in 13 and 2 cases,which showed mild to moderate enhancement in the arterial phase and moderate or more enhancement in the portal phase.The enlarged gallbladder and the severely dilated intrahepatic ducts and common bile ducts proximal to the tumor were seen in all cases.MPR images in 10 cases showed the total aspects of the cholangiocarcinoma.Conclusion On MSCT thin-slice dual-phase enhancement scan and MPR images,the diagnosis of the distal and middle cholangiocarcinoma can be made definitely.