胆管癌的螺旋CT诊断

Diagnosis of cholangiocarcinoma with helical CT

目的探讨螺旋CT扫描在胆管癌的定位、定性及鉴别诊断中的价值。方法CT检查使用美国GE公司HispeedCT/i及CT/e螺旋CT机,扫描范围由膈顶部至肝下,层厚:10mm,5mm,3mm,螺距为1。全部病人均行平扫及增强扫描。结果16例胆管癌中,周围型1例,肝门型9例,肝外胆管型5例,壶腹型1例。CT表现主要为:胆管扩张,梗阻部位的软组织肿块,可伴胆囊炎,胆结石。术前CT正确诊断15例(94%),仅1例误诊为胆管炎。结论螺旋CT扫描对于胆管癌的定位、定性诊断及分型有重要临床价值。

Objective To assess the usefulness of helical CT in the locating diagnosis,the qualitative diagnosis,and the differential diagnosis of cholangiocarcinoma.Methods Sixteen patients with suspected cholangiocarcinoma underwent helical CT scan of the upper abdomen.This examination was performed with U.S.GE Hispeed CT/i and CT/e scanner.Taken 10 mm,5 mm,and 3 mm axial sections were taken pith 1 contiguously from the diaphragm apex through the liver base with and without intravenous contrast media administration.Results The study showed that there were 1 peripheral , 9 portal , 5 extrahepatic bile duct ,and 1 ampullary cholangiocarcinoma in all patients.Among 16 cases,CT directly diagnosed 15 cases(94 % )but only 1 case was erroneously diagnosed as cholecystitis before the operation.The main CT findings were bile duct dilatation,soft tissue masses in the obslructive segments and /or associated with cholecystitis and gallstone.Conclusion Helical CT scans have important usefulness in the diagnosis and the classification of cholangiocarcinoma.