CT胆道成像在胆道梗阻性疾病诊断中的应用价值

The applications value of CT biliary imaging in diagnosis of the biliary duct obstruction diseases

目的 分析多层螺旋CT（MSCT）联合阴性法胆道成像（N-CTC）技术在胆道梗阻性疾病诊断中的应用价值.方法 回顾性分析72例经MSCT联合N-CTC技术检查并经病理或手术证实的胆道梗阻性疾病患者的临床资料,并将检查结果与病理结果对比分析.结果 72例胆道梗阻性疾病患者共81段梗阻性病变,以胰头至十二指肠壶腹水平梗阻较多见,共计44段（54.3％,44/81）;216段胆道中,MSCT联合N-CTC梗阻漏诊率9.9％（8/81）,梗阻误诊率4.4％（6/135）,MSCT联合N-CTC技术在胆道梗阻定位诊断中,与手术或病理比较差异无统计学意义（P＞0.05）.MSCT联合N-CTC容易漏诊较小的低密度结石.结论 MSCT联合N-CTC可对胆道梗阻明确定位、定性,与手术或病理诊断的一致性好,实用、无创,可作为疑诊胆道梗阻的首选检查手段,有广泛的应用前景.

Objective To analyze the multi-slice spiral CT （MSCT） combined negative helical CT cholangiography （N-CTC） technical inspection applications in diagnosis of the biliary duct obstruction diseases.Methods Retrospective analysis of clinical data of 72 patients admitted to hospital by MSCT combined with N-CTC technical inspection and confirmed by pathology or surgery in patients with biliary duct obstructive diseases,and compared with pathological findings.Results Seventy-two cases had 81 paragraph obstruction lesions,with the biliary obstruction of pancreatic head to the level of duodenal ampullary were more common,a total of 44 （54.3%,44/81）;among the 216 biliary paragraph,the missed diagnosis rate of MSCT combined with N-CTC was 9.9% （8/81）,and misdiagnosis rate of obstruction was 4.4% （6/135）,MSCT combined with N-CTC technology in diagnosis of biliary duct obstruction in comparison with surgical or pathological had no significant difference （P 〉 0.05）.MSCT combined with N-CTC easily missed small low-density stones.Conclusions MSCT combined with N-CTC can clearly positioning biliary duct obstruction and qualitatively,consistency with surgery or pathological diagnosis is good,it is practical,non-invasive,can be used as the first choice for suspected biliary duct obstruction means of inspection,has a wide range of applications.