伴有乳头旁憩室的胆囊术后综合征的影像学诊断  

Imaging Diagnosis of Postcholecystectomy Syndrome Complicated with Periampullary Diverticula

作　　者：杨小庆[1] 龚永驰[1] 杨爱玲[1] 邵华[1] 

机构地区：[1]东南大学附属中大医院放射科,南京210009

出　　处：《临床放射学杂志》2005年第4期337-339,共3页Journal of Clinical Radiology

摘　　要：目的　探讨伴有乳头旁憩室(PAD)的胆囊术后综合征的影像学表现。资料与方法　回顾性分析近2 0年来在我院诊治的5 0例伴有PAD的胆囊术后综合征患者的临床和影像学资料。结果　5 0例患者中发现5 4个PAD ,位于乳头上方4 2个,乳头下方7个,乳头开口于憩室内3个,开口于憩室缘2个。PAD直径为0 .5～5 .0cm ,其中>1cm 4 2个(77.8% ) ,同时合并胆管结石35例(70 % ) ,缩窄性乳头炎18例(36 % ) ,胆总管囊肿2例(4% ) ,胰腺癌2例(4% ) ,胆源性胰腺炎1例(2 % )。结论　MRCP和ERCP结合憩室造影对伴有PAD的胆囊术后综合征具有较高的病因诊断准确率,在本病的诊断中具有重要价值。鉴于MRCP的无创伤性和无并发症等优点,在胆囊术后综合征的诊断上可取代诊断性ERCP。Objective To evaluate the imaging manifestations of Postcholecystectomy Syndrome (PCS) complicated with periampullary diverticula (PAD). Materials and Methods The clinical and imaging datas of 50 patients suffered from PCS complicated with PAD in recent 20 years were retrospectively analyzed.Results In 50 patients, there were 54 PADs, of which 42 PADs located above papilla, 7 located below papilla, 3 were papilla in the diverticula, 2 located in the edge of diverticula. The diameters of 54 PADs ranged from 0.5 to 5cm, of which 42 PADs were larger than 1cm (77.8%). In the 50 patents, 35 complicated with cholelithiasis (70%), 18 complicated with constrictive papillitis (36%), 2 with congenital bile duct cyst (4%), 2 with pancreatic cancer (4%), 1 with biliary pancreatitis (2%).Conclusion MRCP and ERCP combined with diverticulogrgaphy have a higher accuracy of diagnosis on causes and play an important role in the diagnosis of PCS complicated with PAD. MRCP can take the place of diagnostic ERCP because of its nonivasive and noncomplications.

关 键 词：胆囊术后综合征 乳头旁憩室 影像学诊断 诊断性ERCP 缩窄性乳头炎 胆源性胰腺炎 MRCP 影像学表现 影像学资料 回顾性分析 胆总管囊肿 诊断准确率 PAD 胆管结石 憩室造影 无并发症 无创伤性 乳头下 胰腺癌 患者 开口 

分 类 号：R445[医药卫生—影像医学与核医学]