胆道梗阻病变的多排螺旋CT诊疗价值探讨

The diagnosis and treatment value of the multi-slice spiral CT on biliary obstructive lesion

目的探讨多排螺旋CT(MSCT)后处理技术对胆道梗阻的诊疗价值。方法回顾性分析经手术病理及随访复诊证实的30例胆道梗阻病例,通过MSCT的多平面重建、曲面重建、最小密度投影等方法显示胆道梗阻的部位、胆管的结构、胆管壁情况及周围组织结构,分析其影像学表现。结果本组显示肝外胆道结石8例,肝门区胆管癌7例,胆总管癌3例,胆囊癌累及胆管1例,胆总管下端及十二指肠乳头区炎症2例,壶腹癌3例,胰头癌6例,MSCT后处理技术对肝外胆道梗阻的定位准确率>90%,定性准确率>95%。结论 MSCT后处理技术对胆道梗阻的定位定性诊断及治疗方案具有重要价值。

Objective To investigate the diagnosis and treatment value of multi-slice spiral CT （MSCT） processing technology on biliary obstruction. Methods 30 cases of bile duct obstruction confirmed by surgical pathology and follow-up referral were retrospectively analyzed, Use the MPR, CPR, MinIP, and other methods of MSCT to show the site of biliary obstruction, the structure of the bile duct, the bile duct wall and the structure of surrounding organization, and analysis its imaging performance. Results Eight cases of extrahepatic bile duct stones, 7 cases of hilar cholangiocarcinoma, 3 cases of bile duct cancer, gallbladder cancer involving the bile duct 1 case,2 cases of inflammation of the bile duct and duodenal papilla area, ampullary carcinoma 3 cases, 6 cases of pancreatic cancer, the positioning accuracy of MSCT post-processing technique of extrahepatic biliary obstruction was〉 90%, qualitative accuracy was〉 95%. Conclusion It has important value of MSCT post-processing technology on the localization and qualitative diagnosis of biliary obstruction, and operation schedule.