ECT对胆道Oddi括约肌功能障碍的研究价值  

Value of ECT in assessing biliary Oddi′s sphincter functional disturbance

作　　者：杨德同[1] 杜明华[2] 吴复平[2] 韩笑苇[2] 史留斌[1] 

机构地区：[1]南京铁道医学院附属医院胆道外科,南京市210009 [2]南京铁道医学院附属医院核医学科,南京市210009

出　　处：《中华肝胆外科杂志》2001年第5期282-284,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　研究99mTc -EHIDA动态功能显像定量分析在Oddi括约肌功能障碍病人的诊断价值。方法　 2 0例Oddi括约肌功能障碍和 38例胆汁淤积病人进行99mTc-EHIDA动态功能显像定量分析 ,并与 2 0例正常人进行比较。用脂餐刺激内源性CCK释放 ;同时对 2 0例Oddi括约肌功能障碍组胆囊排胆分数 (GBEF)与胰胆管造影 (ERCP)胆道测压进行比较。结果　 2 0例Oddi括约肌功能障碍的病例肝脏半排时间 (TEX) ,胆总管高峰时间 (CBDTup) ,胆总管 6 0min排泄率 (CBDE60 ) ,胆总管 90min排泄率 (CBDE90 ) ,胆囊排胆分数 (GBEF) ,胆囊排胆期 (GBEP) ,胆囊排胆率(GBER) ,Oddi括约肌高峰时间 (OddiTup)和十二指肠高峰时间 (DUTup)均与正常人有明显差异 ,P <0 0 5 ;且脂餐后功能障碍组定量分析排泄率明显增加。动态功能显像 ,功能障碍组也有特征性改变 ,即胆道扩张不明显 ,而胆汁淤积 2 0例Oddi括约肌功能障碍的病人 ,99mTc -EHIDA动态功能显像定量分析与胆道测压进行比较 ,结果较一致 ,一致率为 70 %。结论　99mTcObjective To investigate the value of quantitative analysis of 99m Tc-EHIDA hepatobiliary function imaging in patients with Oddi′s sphincter functional disturbance. Methods Quantitative analysis of 99m Tc-EHIDA hepatobiliary function imaging was conducted in 20 patients with functional disturbance of Oddi′s sphincter (group A) and 38 patients with bile accumulation (group B). The results were compared with those in 20 normal controls (group C). Fat meals were administered to stimulate the intrinsic CCK delivery. Meanwhile, the gallbladder ejection fraction (CBEF) in group A was compared with the results of determination of bile tract pressure using ERCP. Results The values of T EX , CBD T up , CBD E 60 , CBD E 90 , GBEF, GBEP, GBER, Oddi T up and DU T up in group A were significantly different form those in group C (P<0 05). The bile excretion was increased after fat meals in group A. The function imaging with ECT showed that there was no marked biliary dilation in group A. The results of quantitative analysis of hepatobiliary function with ECT imaging were coincided with those of the determination of the bile tract pressure. Conclusion 99m Tc-EHIDA quantitative analysis of hepatobiliary function with ECT imaging is of great value in diagnosing bile tract obstruction and evaluating function of Oddi′s sphincter.

关 键 词：放射性核素显像 胆道运动障碍 ODDI括约肌 ECT 

分 类 号：R657.4[医药卫生—外科学] R816.5[医药卫生—临床医学]