PTC对胰胆管合流异常的诊断  

Percutaneous transhepatic cholangiography in diagnosis of pancreaticobiliary maljunction

作　　者：李臻[1] 马骥[1] 韩新巍[1] 

机构地区：[1]郑州大学第一附属医院放射科,河南省郑州市450052

出　　处：《世界华人消化杂志》2008年第9期966-970,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨经皮肝穿刺胆道造影(percutaneous transhepatic cholangiography,PTC)诊断胰胆管合流异常(pancreaticobiliary maljunction,PBM)的可行性,总结其影像学诊断特征.方法:回顾性分析1999-01/2007-02连续257例因阻塞性黄疸(obstructive jaundice,OJ)PTC下行介入治疗患者的临床及影像学资料,确立病例入选标准与PBM诊断参考标准,从中筛选出资料完整、胰管显影的病例35例,测量胆胰共同管长度和直径、汇合处胆胰管直径、汇合角度等,并经校正得到实际数值,结果经统计学处理.结果:PBM确诊31例,PTC检出率为12.06%.共同管长度为9.88±4.55 mm,明显高于正常长度标准(P<0.05).十二指肠乳头位置影响共同管长度大小.汇合处胆总管直径、胰管直径、共同管直径分别为3.20±1.62 mm、2.06±0.82 mm和3.03±1.03 mm,与正常值比较无统计学差异.结论:PTC诊断PBM方法可行、安全、有效,PBM的PTC表现具有一定的特征性.AIM： To investigate the feasibility of percutaneous transhepatic cholangiography （PTC） in the diagnosis of adult pancreaticobiliary maljunction （PBM）, and to summarize its radiological characteristics. METHODS： The clinical data of consecutive 257 patients with obstructive jaundice （OJ） receiving the PTC drainage in our hospital from January 1999 to February 2007 were collected. Clinical findings and cholangiopancreatographic results were retrospectively analyzed. Meanwhile the standard for selecting cases and diagnosing PBM was established. A total of 35 cases were selected and both biliary and pancreatic ducts were opacified. The obtained data were statistically analyzed. RESULTS： PBM was diagnosed in 31 cases, and PTC detection rate was 12.06% （31/257）. The length of common duct and the confluence angle of the pancreaticobiliary ducts were 9.87 ±4.55mm, which were significantly different from normal values （P 〈 0.05）. The site of duodenal papilla had influences on the length of common duct. The diameters of common bile duct, pancreatic duct and common duct near the confluence were 3.20 ± 1.62 mm, 2.06 ± 0.82 mm, 3.03 ± 1.03 mm, respectively. There was no statistical difference between them and the normal values. CONCLUSION： PTC is safe, effective and available to diagnose PBM. PTC finding of PBM has its own characteristics to some extent.

关 键 词：经皮肝穿刺胆道造影 胰胆管合流异常 阻塞性黄疽 

分 类 号：R57[医药卫生—消化系统]