十二指肠乳头旁憩室合并胆系梗阻的MSCT诊断价值

Diagnostic Value of MSCT in Periampullary Diverticulum Complicated with Biliary Obstruction

目的:探讨十二指肠乳头旁憩室合并胆系梗阻的MSCT表现及特点,提高对该病的认识及诊断准确率。方法:回顾性分析28例经ERCP(内镜逆行胰胆管造影)证实的十二指肠乳头旁憩室合并胆系梗阻患者的CT资料,观测憩室位置、大小、密度、胆总管宽度及有无合并结石、感染,运用MPR重组技术多方位显示十二指肠乳头旁憩室与胆管关系。结果:28例患者中,发现十二指肠憩室35个,其中乳头旁憩室28个,CT表现为十二指肠腔外囊袋影,突出于肠管外且与肠腔相通,囊袋内可见气液平、肠内容物、对比剂、气体,28例均见胆道系统不同程度扩张,9例合并胆总管结石,5例合并胆囊结石。结论:十二指肠乳头旁憩室合并胆系梗阻在MSCT检查中有特征性的表现,MSCT有助于提高对该病的诊断准确率。

Objective： To investigate the value of MSCT and evaluate realization in periampullary diverticulum complicated with biliary obstruction. Method： Twenty eight patients with periampullary diverticula and biliary obstruction detected by ERCP were reviewed retrospectively.The position, diameters, densty of PAD and width, gallstones, infection of bile dute were observed and measured.Recombinant technology using MPR multi-dimensional display beside the duodenal papilla diverticulum relationship with bile duct.Result： 35 duodenal diverticulums were found in 28 patients, 28 PAD among them.CT manifestations of duodenal cavity outside pouch, protruding in the intestinal canal and communion with lumen, gas liquid level can be seen in the pouch, intestinal contents, contrast medium, gas, 28 eases were found biliary system expansion, different level 9 cases with common bile duct calculi, 5 cases with gallbladder stones. Conclusion： Periampullary diverticulum complicated with biliary obstruction in MSCT examination performance characteristics, MSCT is helpful to improve the diagnosis accuracy of the disease.