64排螺旋CT诊断肝外胆管癌的临床效果分析

Clinical analysis of 64-slice spiral CT in the diagnosis of extrahepatic cholangiocarcinoma

目的:探讨对肝外胆管癌患者实施64排螺旋CT诊断后获得临床效果。方法:选取聊城市东昌府中医院2018年1月—2020年12月收治的88例肝外胆管癌患者进行诊断研究,临床针对所有患者合理展开64排螺旋CT诊断。结果:88例肝外胆管癌患者中,属于鳞癌患者2例,属于腺癌患者84例(属于高中分化患者4例、高分化腺癌患者38例、中低分化8例、中分化24例,低分化10例),属于腺瘤病变患者2例。对于88例肝外胆管癌患者而言,38例表现出肿块形特点,34例表现出管壁浸润型特点,16例呈现出腔内乳头状现象;对肝门胆管癌58例患者进行分析,18例位于胆总管内部,14例位于左右肝管汇合位置,10例位于左肝管或者右肝管,肿瘤多发或者累及范围广的患者18例;27例属于肿块型;30例中下段胆管癌患者中18例属于胰上段,腔内诸多表现出乳头状病变现象。对患者肿块形胆管癌实施平扫,表现出等密度或者低密度特点,边界不规则并且欠清晰;完成增强扫描后,表现出非均匀强化以及中度强化患者6例;对管壁浸润型病变区域胆管进行观察,呈现出非规则增厚现象,表现出明显强化,厚度在3 mm以上。结论:64排螺旋CT诊断方式有效应用后,对肝外胆管癌可以进行有效诊断,从而对其疾病早期确诊提供有力依据。

Objective To explore the clinical effect of 64-slice spiral CT in the diagnosis of extrahepatic cholangiocarcinoma.Methods A total of 88 patients with extrahepatic cholangiocarcinoma admitted to Hospital of Traditional Chinese Medicine of Dongchangfu District in Liaocheng City,Shandong Province from January 1,2018 to December 31,2020 were selected for diagnostic study.All patients were diagnosed with 64 slice spiral CT.Results Among the 88 patients with extrahepatic cholangiocarcinoma admitted in this study,2 were classified as squamous cell carcinoma,84 as adenocarcinoma(4 as to moderate differentiation,38 as high differentiation,8 moderate to low differentiation,24 as moderate differentiation,and 10 as low differentiation),and 2 as adenomatous lesions.Of the 88 patients with extrahepatic cholangiocarcinoma,38 showed mass,34 showed wall infiltration,and 16 showed intra-luminal papillary appearance.58 cases of hilar cholangiocarcinoma were analyzed,18 cases were located in the common bile duct,14 cases were located in the confluence of the left and right hepatic ducts,10 cases were located in the left or right hepatic ducts,and 18 cases had multiple tumors or a wide range of involvement.27 cases were of mass type.Of the 30 patients with middle and lower segment cholangiocarcinoma,18 belonged to the upper pancreatic segment with many papillary lesions in the lumen.Plain scan was performed on patients with lump-shaped cholangiocarcinoma,which showed iso-density or low-density characteristics with irregular and unclear boundaries.After enhancement scanning,6 patients showed uneven enhancement and moderate enhancement.Irregular thickening of the bile duct was observed in the infiltration lesion area.The thickness was more than 3mm.Conclusion With the effective application of 64-slice spiral CT,extrahepatic cholangiocarcinoma can be effectively diagnosed,thus providing a strong basis for early diagnosis of the disease.