肝外胆管结石的多排螺旋CT评价  

Evaluation of the Extrahepatic Bile Duct Stone with Multi-slice Spiral CT

作　　者：陈勤[1] 许家亮[1] 杨晓生[1] 莫国友[1] 

机构地区：[1]广东省东莞市桥头医院放射科,广东东莞523520

出　　处：《罕少疾病杂志》2012年第6期42-45,共4页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨肝外胆管结石的多排CT特征及并发症的影像表现。材料和方法收集58例行16排CT检查诊断为肝外胆管结石并进行手术治疗的病例资料进行回顾性分析其密度、大小、数目。结果 58例肝外胆管结石的CT表现为高密度结石32.7%(19/58)、混杂密度44.8%(26/58)、泥沙样结石22.5%(13/58),数目和大小不一,肝内外胆管扩张,增强后胆总管下段环形强化。伴发或并发症的CT表现主要为肝内胆管结石21例及胆管积气13例、肝脓肿5例、胆囊结石27例、急性胰腺炎5例、腹水7例、胸腔积液19例、下肺炎症15例。结论肝外胆管结石以胆总管中下段好发,混杂密度结石最常见,急性发作患者易并发胆管炎症及右侧胸腔少量积液。Objective To investigate the major features of extrahepatic bile duct stone with multi- slice spiral CT （MSCT）. Materials and Methods 58 cases with extrahepatic bile duct stone were retrospectively studied, All cases were confirmed by surgery. The density, sizes, location, and numbers of stones were observed on CT plain scan and enhanced scan. Resu/ts 58 cases of extrahepatic bile ducts stones were comprised high density of 19 cases （32.7%）, mixed density of 26 cases（44.8%）, small or low density of 13 cases （22.5%）. They were variety of sizes and the number of stones. The wall of extrahepatic bile duct showed thickening on enhanceed scan. Complication of extrahepatic bile ducts stones included 21 cases of intrahepatic bile duct stones, air with in bile duct （13 patient）, 5 cases of abscess in Liver, 5 cases of pancreatitis, 27 cases of stones in the gallblader, 7 cases of ascites, 19 cases of pleural effusion, 15 cases of low pneumonia. Conclusion extrahepatic bile duct stones appeared as intraluminat the most of mixed density shadows in middle segments of common bile ducts associated with severe dilatation of intrahepatic and extrahepatic bile ducts, the most of complication are acute inflammation and pleural effusion in the right.

关 键 词：胆管结石 X线 断层扫描 

分 类 号：R364.25[医药卫生—病理学] R814.42[医药卫生—基础医学]