口服法螺旋CT胆管造影临床应用价值探讨  

Usefulness of Oral Contrast-Enhanced Helical CT Cholangiography

作　　者：黎雪琴[1] 黄汉涛[2] 张建廷[1] 魏从全[1] 

机构地区：[1]武警湖北总队医院放射科,湖北武汉430061 [2]武警湖北总队医院肝胆外科,湖北武汉430061

出　　处：《实用放射学杂志》2006年第9期1083-1086,共4页Journal of Practical Radiology

摘　　要：目的 探讨口服法螺旋CT胆管造影对胆系疾病的诊断价值和对胆系手术的指导价值。方法 可疑胆系病变患者18例。服用碘番酸后12～14h行CT扫描，并行2D、3DMIP重建。据碘番酸剂量分大剂量组（6．0g）5例，中剂量组（3．0g）10例和小剂量组（1．0g）3例。显影程度分未显影、轻度显影、良好显影和过度显影4级。造影结果与病理和／或临床结果对照。结果 （1）胆管显影与碘番酸剂量有关。观察肝内胆管用量不应〈6．0g，观察肝总管和胆总管3．0g基本满足要求。（2）口服法螺旋CT胆管造影可显示肝内外胆管特别是肝外胆管的解剖结构，反映胆系功能和其通畅情况以及病变与胆管之间的关系，对胆囊阴性结石和胆囊息肉诊断的敏感度为80％，对胆总管阴性结石诊断的敏感度为88．89％，特异度为100％。（3）2D和3D MIP重建空间感好，是原始图像的重要补充。结论 口服法螺旋CT胆管造影简便、无创，是显示肝内外胆管解剖结构和诊断胆系病变的一种较好方法，对胆系手术有指导作用。Objective To study the usefulness of oral contrast - enhanced helical CT cholangiography in the diagnosis and treatment for bile duct diseases. Methods 18 cases of suspected bile duct diseases were studied. The dose of iopanoic acid was 6.0 gram （ n = 5 ） , 3.0 gram （n=10） and 1.0 gram （n=3）. CTscan was performed 12 -14 h after administration. Reformatted2D and3D M IPimages were got from axial source images. The opacified degree of bile duct was described as no opacification, light opacification, well opacification or over opacification . The findings of CT chonlangiography were compared with pathological and / or clinical results . Results （ 1 ） The dose of iopanoic acid could effect the opacified degree of bile duct. It should be more than 6.0 gram to investigate intrahepatic bile duct, and 3.0 gram should be enough to investigate extrahepatic bile duct ; （ 2 ） Intra - and extrahepatic bile duct anatomy could be display clearly , especially the extrahepatic duct. Function of bile duct system, relations between lesion and bile duct, and the obstructed degree of bile duct could be revealed too. Sensitivity was 80% in diagnosis of negative gallstone and gallpolypus . Sensitivity was 88.9% and specificity was 100% in diagnosis of negative gall- stone in general bile duct ; （3） 2D and 3D MIP reconstructions displayed the spatiality of bile duct better. Conclusion Oral contrast - enhanced helical CT cholangiography is feasible and noninvasive. It is a well method in revealling the bile duct anatomy and diagnosing the bile duct lesions, and is useful for bile duct operations.

关 键 词：胆管造影 体层摄影术 X线计算机 口服对比剂 

分 类 号：R322.48[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]