金属胆道支架梗阻原因的三维增强MDCT评价  

Evaluation of metal biliary stent occlusion by three dimensional contrast enhanced MDCT

作　　者：郭子义[1] 李晓光[2] 

机构地区：[1]海口市人民医院放射科,海南海口570208 [2]北京协和医院放射科,北京100730

出　　处：《海南医学》2014年第17期2544-2547,共4页Hainan Medical Journal

基　　金：海口市科工信局重点计划项目(编号:2012075)

摘　　要：目的评价动态增强高分辨率三维多层CT在鉴别不同原因所致金属胆道支架梗阻的方法及价值。方法选取2012年1月至2014年3月期间因金属胆道支架置入术后黄疸复发来院行高分辨率动态增强CT检查的9例患者,共置入金属胆道支架14枚。根据多平面重建、容积再现、最大密度投影等方法,分别针对导致金属支架狭窄的原因,如肿瘤覆盖(Overgrowth)、肿瘤长入(Ingrowth)、金属支架移位(Migration)和支架断裂进行逐一显示。结果多平面重建在本组全部14枚支架出现软组织密度所致梗阻的位置,范围方面显示率最高,最大密度投影在显示支架破损位置和个数方面显示效果最佳,对支架移位及邻近关系改变需要通过多平面重建、最大密度投影和容积再现技术综合显示。结论基于高分辨率动态三维多层CT的后处理技术能够准确诊断恶性胆道支架再狭窄原因,有利于对患者的进一步治疗。Objective To evaluate the usefulness of three dimensional contrast enhanced multidetector computed tomography （MDCT） for the assessment of causes of biliary stent occlusion. Methods Between January 2012 and March 2014, 9 patients suspected biliary stent occlusion with recurrent jaundice by unresectable malignant biliary obstruction were enrolled in the study. A total of 14 metal biliary stents were evaluated by the Maxum Intensity Projection （MIP）, Volume Rendor （VR）, curved planar reformation （CPR）. Complications of metallic stent placement for malignant bile duct obstruction, including tumor ingrowth or overgrowth, viscus perforation, and stent migration were individually displayed. Results MPR technique was used to display the obstruction position, with the highest ratio. When coming to the fracture position, stent migration and adjacent relationship, MIP displayed more clearly than other technique in our current 14 metal biliary stents. For stents migrations and fractures, the MPR combined MIP and VR was found to be preferred. Conclusion A technology of non-invansive diagnosis of malignant biliary stent occlusion is readilly dispayed by high resolution 3D contrast enhanced CT and beneficial to further treatment of patients.

关 键 词：多层CT 金属胆道支架 恶性梗阻 黄疸 

分 类 号：R657.4[医药卫生—外科学]