64层螺旋CT检查在胆管癌诊断中的价值

Value of 64-slice spiral CT in diagnosis of cholangiocarcinoma

目的探讨64层螺旋cT在胆管癌的定位、定性及术前诊断中的价值。方法收集山西省人民医院2008年至2011年间，经CT术前检查、手术病理证实的36例胆管癌患者的临床资料。CT检查使用西门子Sensa—tionCardic64层螺旋CT机，扫描范围由膈顶部至双肾门水平，层厚7mm，重建1～3mm，螺距为1。全部患者均行平扫、增强双期扫描（动脉期、静脉期）。结果36例胆管癌患者中周围型6例，肝门型14例，肝外胆管型10例，壶腹型6例。CT表现主要为胆管扩张，梗阻部位的软组织肿块，可伴胆囊炎、胆结石，肝转移7例，伴肝硬化3例，腹水10例，胰腺转移5例，小网膜囊及十二指肠侵犯3例，大网膜转移5例，淋巴结转移7例。结论64层螺旋CT扫描对于胆管癌的定位、定性诊断及术前评估有重要临床价值。

Objective To evaluate the value of 64-slice spiral CT in the locacization, qualitative and preoperative diagnosis of cholangiocarcinoma. Methods The clinical data of 36 cases of cholangiocarcinoma proved by pathology and CT scan from 2008 to 2011 in our hospital were collected. 64-slice spiral CT was used, the scan range was from diaphragmatic dome to renal hilar level, the layer thickness was 7 mm, the reconstruction thickness was 1 -3 mm, the pitch was 1. All the patients were under non- contrast scan and contrast scan（ arterial phase and venous phase）. Results Among the 36 patients with cholangiocarcinoma, 6 patients were peripheral, 14 patients were portal type, 10 patients were extrahepatic bile duct type, 6 patients were ampullae type. CT findings were： cholangiectasis, soft tissue at the obstruction, accompaned with cholecystitis and cholecystolithiasis. Seven patients were aeeompaned with hepatic metastasis, 3 cases with hepatic cirrhosis, 10 cases with seroperitoneum, 5 cases with pancreatic metastasis, 3 cases with lesser sac and duodenum violation, 5 cases with omentum metastasis, 7 cases with lymph node metastasis. Conclusions 64-slice spiral CT have a great clinical value for location, qualitative diagnosis and preoperative evaluation of cholangiocarcinoma.