多层面螺旋CT胆道造影成像临床应用评价

Clinical evaluation of the post-processing imaging techniques of multi-slice helical CT cholangiography

目的评价多层面螺旋CT胆道造影各种成像方法的临床价值 ,分析不同成像方法对诊断胆系疾病的优势与限度。方法对 4 7例B超诊断胆系疾病而多层面螺旋CT常规检查无异常者 ,行多层面螺旋CT胆道造影成像检查 ,将原始资源图像在工作站上行后处理成像 ,对后处理图像诊断结果与手术及胆道镜结果进行对照 ,比较各种后处理图像的诊断价值。结果多层面螺旋CT胆道造影成功成像 4 5例 ,诊断胆系结石 31例 ,多层面螺旋CT仿真内窥镜对胆系结石特异度、敏感度均最高 ,诊断胆总管炎、胆管癌各 3例 ,各种成像方法诊断价值相似。胆囊息肉 3例仅CT仿真内窥镜能做出正确诊断。B超诊断异常者 5例 ,多层面螺旋CT胆道造影未见异常。结论多层面螺旋CT仿真内窥镜 ,透过性X线投影法及多层面重建为有价值的后处理成像方法 ,多层面重建适于观察胆道管壁 ,对各种胆道疾病均有诊断价值 ,仿真内窥镜显示管腔内结构优于其它各种方法。

Objective To evaluate different post-processing imaging techniques of multi-slice helical CT cholangiography (MSCTC). Methods Fourty-seven patients were suspected of bile duct disease by ultrasound, with no abnormality by ordinary CT. These patients then received MSCTC examination. The original images were post-processed at workstation. The result of post-processed images was compared with that of the laparotomy and surgical bile duct endoscopy. Results Procedures were successful in 45 cases. Thirty-one cases were found with choledocholithiasis. The specificity and the sensitivity of CT virtual endoscopy (CTVE) for choledocholithiasis group were high. Cholangitis and cholangiocarcinoma were detected in 3 each cases.Three cases were finally found to have gallbladder polypus, in which only CTVE provided the diagnosis. The diagnosis of bile duct disease made by ultrasound were finally excluded by CTVE. Conclusions KG1 The available post-processing methods are CTVE and X-proj, MPR is applicable for observing bile duct wall, it is valuable in the diagnosis of all kinds of bile duct disease. CTVE is better than other methods at displaying intraluminal structure.