经Vater壶腹灌注对比剂64排螺旋CT胰胆管成像

Assessment of pancreatic and biliary ducts using multiplanar reformatted images in 64-slice CT following perfusion with iohexol via ampulla of Vater

目的通过早产儿尸体标本Vater壶腹内灌注对比剂,64-MSCT显示胰胆管及其周围组织结构,为进一步研究提供依据。方法通过对15例不同胎龄早产儿尸体解剖十二指肠乳头后,采用插管法对十二指肠乳头肌内灌注对比剂后,行64-MSCT扫描并结合三维重建,所得图像由两位高年资医师独立阅片并达成一致意见,将十二指肠乳头肌和胰胆管分别取材,进行HE染色。结果共15例早产儿组织学标本,9例胰胆管同时显影,可见共同管,5例胆总管显影,1例胰管显影。胰胆管合流方式:Y型11例,U型2例,V型1例,Ⅱ型1例。乳头肌形态及位置:乳头肌有9例呈半球状、3例呈扁平状、3例呈柱状;2例发现有小乳头。9例乳头位于十二指肠中部1/3,2例位于上部1/3,3例位于下部1/3,1例位于十二指肠远端。结论经早产儿标本乳头肌内灌注对比剂后64-MSCT结合三维重建可以清晰显示胰胆管合流方式、共同管和周围组织结构。

Objective To delineate the structure of the pancreatic and biliary ducts in premature infants using a novel imaging method. Methods The duodenal papillae of 15 premature infant cadavers were dissected. The pancreatic and biliary ducts were visualized using a 64-detector multislice spiral computed tomography （MSCT）. Contrast agent was injected into the duodenal papillae via the ampulla of Vater. Results The pancreatic, biliary ducts as well as the common channel could be visualized with CT scanning in nine cases. The common bile duct was visualized in five cases and the pancreatic duct in one case. Four patterns of the pancreaticobiliary ductal junction were noticed： type-Y （11/15）, type-U （2/15）, type-Ⅴ （1/15） and type-Ⅱ （1/15）. Conclusion MSCT and three-dimensional reconstruction could be used to visualize the junction pattern, common channel and surrounding tissue structure of the pancreatic and biliary ducts in premature infants.