螺旋CT多平面重组诊断急性胆道穿孔与手术对照研究  

Helical CT with MPR in diagnosis of acute biliary perforation correlated with surgical findings

作　　者：吴晓[1] 黄小燕[1] 何剑[1] 

机构地区：[1]湖州师范学院附属湖洲市中心医院放射科,浙江313000

出　　处：《放射学实践》2011年第6期610-612,共3页Radiologic Practice

摘　　要：目的:回顾性分析急性胆道穿孔CT影像表现与手术所见,研究CT诊断要点,以求进一步提高诊断准确性。方法:对28例患者均采用CT平扫加增强,将层厚1 mm,层距0.5 mm薄层图像传至CT工作站,利用多平面重建(MPR)方法重建图像。结果:28例病例中22例利用MPR重组发现破口。25例显示胆囊或胆总管张力明显减低,胆囊、胆总管壁皱缩;胆囊壁增厚22例,明显增厚5例;3例表现为胆囊增大;25例可见胆囊窝周围及腹腔积液。胆道周围蜂窝织炎8例。结论:经过对28例急性胆道穿孔患者CT表现与手术结果对照研究,认为CT可根据胆囊壁连续性中断、胆道外形皱缩、局部张力明显减低、腹腔积液以胆囊窝及胆道周围为主等典型征象,作出明确诊断。螺旋CT-MPR重组与横断面图像相比更有利于发现胆道破口。Objective：To retrospectively analyze the CT imaging and surgical findings of the acute biliary tract perforation in order to further improve the diagnostic accuracy on the basis of the CT features.Methods：The plain and contrasted CT scans were perfomed in 28 cases,and the images using 1mm slice thickness and 0.5mm slice interval were transmitted to the workstation to create the images by multiplanar reformations（MPR）.Results： The crevasse of biliary tract in 22 of 28 cases were found by MPR.Twenty-five cases showed the decreased tension of the gallbladder or the common bile duct and shrinkage of the walls.The thickness of gallbladder wall increased in 22 cases,and increased significantly in 5 cases.Gallbladder distended in 3 cases.The fluid collection in fossa of gallbladder and ascites were observed in 25 cases.Peribiliary phlegmonous inflammation was detected in 8 cases.Conclusion：The acute biliary tract perforation could be diagnosed definitely with the CT features including the gallbladder wall disruption,biliary tract shrinkage,local tension loss,and fluid collection in or near the gallbladder fossa.CT MPR is more useful to find the biliary crevasse than the transverse CT images.

关 键 词：胆道疾病 体层摄影术 X线计算机 图像处理 计算机辅助 

分 类 号：R657.4[医药卫生—外科学]