螺旋CT胆囊成像对胆囊疾病的诊断价值

Diagnostic value of spiral CT cholecystography for gallbladder lesions

目的 :评价螺旋CT胆囊成像对胆囊疾病的诊断价值。方法 :43例胆囊疾病者中胆囊结石 2 7例 ,胆囊癌 9例 ,胆囊息肉 7例 ;利用口服胆囊造影CT和静脉输入胆道对比剂Biliscopin相结合 ,行上腹部螺旋CT容积扫描 ,在工作站利用软件将图像处理后得到胆囊及胆管系统立体图像。结果 :2 7例胆囊结石中 10例为阳性结石 ,17例为阴性结石 ;胆囊四维图像上 ,胆囊结石显示为 1个或多个类圆形阴影或致密影 ,与胆囊壁分界清楚 ,并可以旋转观察结石的位置、大小、形态 ;而 7例胆囊息肉则显示附着在胆囊壁上小的乳头状结节 ,1个或多个 ,与胆囊壁连成一体 ;9例胆囊癌则显示为较大结节 ,表面可不光整 ,与胆囊壁相连处基底较广 ,或胆囊壁广泛增厚 ,胆囊腔较小。MPR图像上 ,胆囊结石者清楚显示胆囊内结石为阳性或阴性结石 ,以及形态、大小 ;胆囊息肉者清楚显示息肉大小、位置 ,表面光滑 ;胆囊癌者显示肿块位置、大小 ,肿块表面不光整 ,胆囊壁不规则局部增厚或广泛增厚。结论 :螺旋CT胆囊成像作为一种准确而无创伤性检查方法 ,对胆囊疾病诊断具有重要意义。

Objective:To evaluate the spiral CT cholecystography with three dimentional reconstruction for diagnosis of gallbladder lesions.Methods:Combining oral and intravenous cholecystgraphic CT,43 patients underwent single breath hold upper abdominal spiral CT volume scanning.After processing images at the workstation,three dimentional images of gallbladder and bile ducts were obtained.Results:Of 43 patients,there were 27 cases of gallbladder stone,9 cases of gallbladder carcinoma and 7 of polyp.On four dimentional images of gallbladder,calculus manifested as multiple or single round filling defect and clearly separated from the wall;polyps showed palillary nodule attached to wall;carcinoma was characterized as large nodule attached to wall or diffuse thickening of gallbladder wall.On MPR imaging,calculus appeared radiopaque or radiolucent;In polyp and carcinoma,the size,location and surface of lesion were clearly demonstrated.Conclusions:Spiral CT cholecystgraphy with three dimentional reconstruction is a noninvasive and accurate procedure,it has great value for diagnosis of gallbladder lesions.