肝内胆管脓肿的CT特征探讨  

A study on CT features of intrahepatic bile duct abscess

作　　者：闵鹏秋[1] 李鹏[1] 何之彦[1] 陈卫霞[1] 刘燕[1] 

机构地区：[1]华西医科大学附属第一医院,成都610041

出　　处：《中华放射学杂志》2001年第5期362-366,共5页Chinese Journal of Radiology

摘　　要：目的　探讨肝内胆管脓肿 (intrahepaticbileductabscess,IBDA)的CT表现特点及病理基础。方法　回顾性研究 1989年 10月至 1999年 2月经手术及临床抗炎治疗后复查证实的IBDA连续性病例 31例的CT资料。病因包括多种原因所致的急性梗阻性化脓性胆管炎和胆道逆行感染。所有病例分别从肝脓肿征象、胆源性征象及反映两者间相关性的征象进行观察。结果　 31例中均可见肝脓肿CT表现特征 (31/ 31,10 0 % )。胆源性CT表现包括各种梗阻病因的特征性CT表现和其他胆道异常表现 ,包括胆管扩张 (2 9/ 31,93 5 % )、扩张的胆管与脓肿相通 (5 / 31,16 1% )或相紧邻 (8/ 31,2 5 8% )及胆道积气 (10 / 31,32 2 % )等。前两者间相关的CT表现 ,包括肝脓肿与梗阻点及其近侧扩张胆管相一致 (15 / 31,48 4% ) ,肝脓肿发生于无 (7/ 31,2 2 6 % )或有 (4/ 31,12 9% )肝内胆管积气的肝叶、肝段等。结论　IBDA的CT表现包括肝脓肿征象、胆源性征象 ,并能反映两者间相关的具有一定特征的CT征象。Objective To evaluate CT features of intrahepatic bile duct abscess (IBDA) and its pathologic basis. Methods The CT imaging data of 31 consecutive cases of intrahepatic bile duct abscess proved by surgery or clinical treatments from October 1989 to February 1999 were retrospectively studied. The causes included acute obstructive suppurative cholangitis and retrograde infection due to different etiologies. For all the cases, the CT manifestations of liver abscess, bile duct abnormalities, and their relationship were observed respectively. Results Manifestations of liver abscess were revealed in all cases (31/31,100%). The CT manifestations of bile duct abnormalities included signs of etiologies caused bile duct obstruction and other signs including cholangiectasis (29/31, 93.5%), the dilated bile ducts communicated with (5/31,16.1%)or abut on (8/31,25.8%) the abscesses, and gas collection in bile ducts (10/31,32.2%). The signs showing the relationship between liver abscess and bile duct abnormalities were that the abscesses complied with the obstructive site and the dilated bile ducts (15/31,48.4%), and the liver abscesses located in different (7/31,22.6%) or same (4/31,12.9%) liver lobes or segments with gas collection in the dilated bile ducts. Conclusion The CT manifestations of IBDA included signs of liver abscess, abnormalities of bile ducts, and signs showing their relationship. CT scanning was helpful in making comprehensive and accurate diagnosis of IBDA.

关 键 词：肝内胆管脓肿 CT 诊断 病理 外科手术 

分 类 号：R816.5[医药卫生—放射医学]