低张力多层螺旋CT胆管曲面重建与ERCP对肝外胆管梗阻病变诊断的对比研究  

Comparative Study of Curved Planar Reconstruction with Low-tension MSCT and ERCP in Diagnosis of Extrahepatic Biliary Obstructive Disease

作　　者：陈刚文[1] 阳祥春[1] 王建秋[1] 王文兵[2] 张文礼[2] 贺军[1] 

机构地区：[1]四川省宜宾市第一医院放射科,四川宜宾644000 [2]四川省宜宾市第一医院消化科,四川宜宾644000

出　　处：《实用放射学杂志》2009年第10期1455-1458,1462,共5页Journal of Practical Radiology

摘　　要：目的比较多层螺旋CT（MSCT）胆管曲面重建（CPR）与内窥镜逆行性胰胆管造影（ERCP）对肝外胆管梗阻的定性诊断价值。方法61例经B超检查提示有肝外胆管梗阻的患者均行CT增强扫描和ERCP检查。门静脉期采用3mm层厚、2．0螺距扫描。原始资料经1mm层厚、0．625mm间距重建，获得轴面源图像（ASI），数据传输至工作站做胆管CPR。对比分析胆管CPR、ERCP对肝外胆管梗阻病变的定性诊断价值。结果胆管CPR、ERCP对来源于胆管壁、管腔内的梗阻病变有很高的诊断价值，两者无显著差异性（P〉0．05）；胆管CPR对胆管外的病变诊断符合率显著优于ERCP（P〈0．01）；ERCP对十二指肠乳头区的病变诊断符合率高于胆管CPR（P〈0．01）。结论不同部位、不同原因引起的肝外胆管梗阻，ERCP、胆管CPR各有优缺点。灵活选取不同的影像学检查方法可提高诊断的准确性。Objective To compare the qualitative value of curved planar reconstruction（CPR） with muti-slice spiral CT（MSCT） and ERCP for extrahepatic biliary obstructive diseases. Methods MSCT contrast-enhanced scans and ERCP were performed ifi 61 cases with extrahepatic biliary diseases in whom previously had received ultrasound. 3 mm collimation thickness and 2.0 pitch were chosen in portal venous phase. The raw data was first reformated to bring out axial source images（ASI） with 1 mm collimation thickness and 0. 625 mm reconstruction interval. The ASI image data were transferred to workstation and dealt with CPR. The CPR and ERCP were compared in the qualitative diagnosis of extrahepatic biliary diseases. Results The CPR and ERCP were of high value for the diseases sourced from biliary wall and lumens, there was no significant difference between them（P 〉 0.05）. The qualitative diagnosis of CPR in extrabiliary was significantly higher than that of ERCP（P〈0.01 ）. The diagnostic value of ERCP for the diseases in the duodenal papilliary region was significantly higher than that of CPR（P〈0.01 ）. Conclusion The CPR and ERCP have advantages and disadvantages of different obstructive spot and obstructive cause in extrahepatic biliary obstructive diseases respectively. It may be necessary to choose imaging examination flexiblely to extrahepatic biliary obstructive diseases.

关 键 词：胆管梗阻 曲面重建 体层摄影术 X线计算机 内窥镜逆行性胰胆管造影 

分 类 号：R575.7[医药卫生—消化系统] R814.42[医药卫生—内科学]