小儿先天性胆管囊肿的CT诊断(附21例报告)

CT diagnosis of children's congenital choledochalcysts:A report bf 21 cases.

目的 探讨小儿先天性胆管囊肿的CT诊断及鉴别诊断。方法 对21例经手术和/或病理证实的资料完整的小儿胆管囊肿病例进行回顾性分析。结果 21例先天性胆管囊肿的CT表现如下:(1)单纯胆总管囊性扩张13例,表现为肝门区或胰头区附近圆形的水样密度灶,增强囊内无变化。(2)肝内胆管多发囊性扩张2例,表现为肝内多个囊状、梭状低密度灶,增强后,可见其内有中心点状及树枝状明显强化灶。(3)肝内外胆管多发囊性扩张6例,同时具有以上两种征象。本病需与胰头囊肿、右肾囊肿、肠系膜囊肿、肝内单发或多发囊肿、梗阻性肝内胆管扩张等病鉴别。结论 CT是诊断小儿先天性胆管囊肿的重要方法。

To investigate CT diagnosis and differential diagnosis of children' s choledochal cyst. Methods 21 cases of children's congenital choledochal cysts diagnosed by either surgery or pathology were studied. The CT findings of all these cases were analyzed. Results The CT findings were as followings: CD dilated solitary extrahepatic choledochus (n = 13): Water - like density in shape of round or ellipse without enhancement were presented around the hepatic portal area and the head of pancreas. (2) Multiple intrahepatic bile duct dilatation (n = 2): which showed as multiple low density of sackform or fusiform inside the area of liver, and obvious spot - like and dendritic enhancement can be found inside the lesions when enhanced. (3) Multiple hepatic bile duct dilatation (n =6): both of the findings above were presented at the same time. This disease should be distinguished with pancreatic cyst, right renal cyst, mesenteric cyst, solitary or multiple hepatic cysts, and obstructive intrahepatic bile duct dilatation. Conclusion CT should be an important examination method in diagnosing children's congenital choledochal cyst.