胆总管下段梗阻的CT诊断

CT diagnosis of obstruction in the lower segment of the common bile duct

目的 :探讨CT对胆总管下段梗阻的病因诊断。方法 :用全身CT扫描机对腹部平扫和增强扫描 ,对经手术病理证实的 45例胆总管下段梗阻的CT表现进行分析。结果 :45例胆总管下段梗阻均有胆总管梗阻端以上扩张 ,8例伴有胰管扩张 ,其中胆总管下段结石 2 8例 ,壶腹癌 8例 ,胆总管癌 4例 ,十二脂肠乳头癌 2例 ,胆总管囊肿 2例 ,慢性胆管炎 1例。CT图象各有其特征性表现 ,定性准确率 86.67%。结论 :CT对胆总管下段梗阻定位准确 ,定性率较高。

Objective To study the etiological diagnosis of obstruction in the lower segment of the common bile duct by CT. Methods Whole body CT scanning-machine was used to perform plain scan and enhanced scan. CT findings were analyzed in 45 cases of pathological proved obstruction in the lower segment of the common bile duct. Results All these 45 cases were found enlargement of the upper part of the obstructed end of common bile duct, in which 28 cases were found stone in the lower segment of the common bile duct, 8 were carcinoma of ampulla, 4 were cancer of common bile duct, 2 cancer of duodenal papilla, 2 common bile duct cyst, 1 chronic cholangitis; and 8 cases were complicated with pancreatic duct enlargement. CT findings were different with the diseases. The diagnostic accordance rate was 86.67%. Conclusion CT can accurately define the level of lower segment of common bile duct obstruction with high diagnostic accordance rate.