经皮肝穿刺螺旋CT三维胆系造影对阻塞性胆管病变诊断价值的探讨  

Assessment of three-dimensional spiral CT cholangiography in patients with obstructive biliary disease after percutaneous transhepatic cholangiography

作　　者：张增芳[1] 李振家[2] 武乐斌[2] 柳澄[2] 崔允峰[3] 

机构地区：[1]山东大学山东省医学影像学研究所,山东济南250012 [2]山东省医学影像学研究所,山东济南250021 [3]山东大学第二医院放射科,山东济南250033

出　　处：《医学影像学杂志》2005年第2期137-140,共4页Journal of Medical Imaging

摘　　要：目的 :研究三维螺旋CT经皮肝穿刺胆系造影 (3D SCT PTC)对胆管梗阻性病变的临床应用价值。方法 :对 31例胆管扩张的患者 ,常规CT扫描图像选择穿刺胆管和针道。螺旋CT扫描从膈顶至胰腺钩突区 ,以MIP、SSD和曲面重建法合成三维胆管树影像。结果 :31例病人中 ,30例 (96 .8%)经皮肝穿刺胆系造影成功。 30例螺旋CT胆系造影均显示了胆管梗阻的部位、原因、程度及范围 ,2 7例 (90 %)胆管解剖和异常在MIP和曲面重建图像比轴位图像显示清楚。结论 :螺旋CT经皮肝穿刺胆系造影可避免常规X线PTC穿刺的盲目性 ,对比剂使用伊索显 ,用量少 ,并发症少 ,对梗阻的部位、原因、程度判断准确可靠 ,对明显胆管梗阻性病变的患者不失为一种有用的检查方法。Objective:To study the clinical value of three-dimensional spiral CT-PTC in obstructive biliary diseases.Methods:31 cases with obstructive biliary diseases were involved in the study. Needles were performed according to axial CT images,and contrast agent was injected.Thirty patients underwent upper abdomingal spiral CT scanning and three-dimensional biliary tree imaging was reconstructed.Results:SCT-PTC was performed successfully in 30 cases (96.8%) and 3D-SCT-PTC images indicated positions, causes, extents of obstructive diseases. In 27cases(90%), MIP images were more informative than axial images for biliary anatony and abnormalities.Conclusion:3D-SCT-PTC is an important way to examine the patients with serious obstructive biliary diseases.

关 键 词：经皮肝穿刺胆系造影 胆管梗阻 体层摄影术 X线计算机 

分 类 号：R575[医药卫生—消化系统] R814.42[医药卫生—内科学]