110例经皮肝穿刺胆管造影示胆系狭窄或梗阻段的X线图象分类

MORPHOLOGIC CLASSIFICATION IN 110 CASES OF PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY

根据110例胆系狭窄或梗阻病人经皮肝穿刺胆管造影(PTC)所见,将X线图象分为几种类型:杯口型(63例)均为结石;浅凹型(2例)、平秃型(14例)、圆秃型(8例)、尖削型、(8例)、象鼻型(5例)多由癌肿或恶性肿瘤造成:狭段型(7例)提示良性病变;外压型(3例)系外在恶性肿瘤如转移性淋巴结压迫所致。此分类法有助于对诊断不明的黄疸病人作出初步诊断。

Since 1978, percutancous transhcpatic cholangiography (PTC) has been performed in 110 patients with jaundice of unknown etiology. With references from operative findings and pathologic diagnoses, these cholangiograms were studied retrospectively. Thc authors made the following morphologic classification of x-ray appearances of bile duct, which might be helpful in the differential diagnosis between malignant and benign diseases. The type with cupping at visualized common bile duct (CBD) end (63 cases) indicated choledocholithiasis. Segmental narrowing of CBD (7 cases) dcnoted benign lesions. Types suggesting malignant lesions were shallow depression end (2 cases), knife-cut end (14 cases), round smooth end (8 cases), tapered end (8 cases) and elephant nose end (5 cases) of the visualized CBD and external impression on the bile duct (3 cases). There were only a few exceptions.