腹腔镜胆囊切除术前利用256层螺旋CT血管成像技术评估胆囊动脉

Cystic artery assessment with 256-slice spiral CT angiography before laparoscopic cholecystectomy

目的经过256层螺旋CT血管成像技术察看胆囊癌、胆囊炎时胆囊动脉显示状况、能否影响胆囊动脉起源,并测量胆囊动脉管径及横截面积。方法选取在我院行上腹增强扫描检查并提示胆囊癌、胆囊炎及胆囊未见异常患者的影像资料,观察并记录各组资料胆囊动脉显示率、显示评分、起源,并测量胆囊动脉直径及横截面积。结果胆囊炎组91例,胆囊动脉显示率96.7%(88/91),其中胆囊动脉起源变异13例(14.8%),88例患者中,显示评分1分19例、2分69例;胆囊癌30例,胆囊动脉显示率96.7%(29/30),其中胆囊动脉起源变异5例(17.2%),29例患者中,显示评分1分3例、2分26例;胆囊正常组100例,胆囊动脉显示率94.0%(94/100),其中胆囊动脉变异16例(17%),94例患者中,显示评分1分58例、2分36例。各组间进行统计分析,胆囊动脉显示率及起源变异无统计学意义(P>0.05),胆囊动脉显示评分有统计学意义(P<0.05);对各组胆囊动脉直径及横截面积的测量:胆囊炎症组98支,直径平均(1.99±0.39)mm,横截面积平均(3.30±1.25)mm2,胆囊癌组30支,直径平均(2.44±0.69)mm,横截面积平均(5.11±3.46)mm2,胆囊正常组101支,直径平均(1.78±0.30)mm,横截面积平均(2.59±0.83)mm2,各组间比较,有显著差异(P<0.05)。结论胆囊合并胆囊炎及胆囊癌时256层螺旋CT可以很好的评估胆囊动脉,能够作为腹腔镜胆囊切除术的术前检查。

Objective By means of 256-slice spiral CT angiography,we observed the displaying status of cystic artery and whether this modality will affect the origin of the cystic artery in the process of during gallbladder carcinoma or cholecystitis,and then,measured the pipe diameter and cross sectional area of cystic artery.Methods The patients with carcinoma of gallbladder,cholecystitis or patients with normal gallbladder imaging situation,as evidenced by the abdominal enhancement CT in our hospital,were selected in this work.We observed and recorded the data of each group in terms of the rate,the scores and the origin of display of cystic artery,and also,measured the pipe diameter and cross sectional area of cystic artery.Results Of 91 cases in the group of cholecystitis,the displaying rate of cystic artery were 96.7%(88/91),among which 13 cases exhibited original abnormality of cystic artery(14.8%),88 cases were displayed the score of cystic artery for 1 point in 19 cases and for 2 points in 69 cases.Of 30 cases in the group of gallbladder carcinoma,the displaying rate of cystic artery were 96.7%(29/30),among which 5 cases exhibited original abnormality of cystic artery(17.2%),29 cases were displayed the score of cystic artery for 1 point in 3 cases and for 2 points in 26 cases.Of 100 cases in the group of normal gallbladder,the displaying rate of cystic artery were 94.0%(94/100),among which 16 cases exhibited original abnormality of cystic artery(17%),94 cases were displayed the score of cystic artery for 1 point in 58 cases and for 2 points in 36 cases.The statistical analysis of the results from different groups showed that there were no statistical significance in the displaying rate of cystic artery and the original abnormality of cystic artery(P>0.05).However,the scores of displaying the cystic artery had statistical significance(P<0.05).As for the measurement of the pipe diameter and cross sectional area of cystic artery,in the group of cholecystitis,there were 98 pieces,with an average of(1.99±0.39)mm in the pipe diameter and with an average of(3.30±1.25)mm 2 in the cross sectional area of cystic artery;in the group of gallbladder carcinoma,there were 30 pieces,with with an average of(2.44±0.69)mm in the pipe diameter and with an average of(5.11±3.46)mm 2 in the cross sectional area of cystic artery;and in the group of normal gall-bladder,there were 101 pieces,with an average of(1.78±0.30)mm in the pipe diameter and with an average of(2.59±0.83)mm 2 in the cross sectional area of cystic artery.Compared the results in each group,there were significant differences(P<0.05).Conclusion 256-slice spiral CT angiography can evaluate cystic artery well,which can be used as preoperative examination for laparoscopic cholecystectomy.