64层螺旋CT阴性法胆管成像技术在胆管梗阻性疾病中的应用观察  

The application of negative CT cholangiopancreatography on evaluating biliary duct obstruction by using 64 slice CT

作　　者：张春雷[1] 朱玉春[1] 王建良[1] 沈纪芳[1] 

机构地区：[1]江苏大学附属昆山医院,昆山市第一人民医院,江苏昆山215300

出　　处：《基层医学论坛》2014年第31期4250-4252,F0003,共4页The Medical Forum

基　　金：昆山市2013年度社会发展计划指导性项目(KSZ1310)

摘　　要：目的探讨64层螺旋CT阴性法胆管成像技术对胆管梗阻病变的诊断价值。方法对105例临床诊断为梗阻性黄疸患者行中上腹部64层螺旋CT平扫和增强扫描,对CT数据进行CT阴性法胆管重建(negative CT cholangiopancreatography,N-CTCP)包括多平面重建法(multiplanar reconstruction,MPR)、曲面重组法(cured planar reformation,CPR)及最小密度投影(minimum intensity projection,MIP),对梗阻原因进行定位、定性诊断,并与手术结果进行对照。结果本组105例中,采用64层螺旋CT横断位和N-CTCP重建对梗阻部位定位诊断率均为100%,而CT横断位定性诊断率为82.9%(87/105),结合N-CTCP重建定性诊断率为93.3%(98/105)。对于良性病变(69例),CT横断位诊断准确率85.5%(59/69),结合N-CTCP重建诊断准确率92.8%(64/69),误诊和漏诊5例;对于恶性病变36例,CT横断位诊断准确率77.8%(28/36),N-CTCP重建诊断准确率94.4%(34/36),误诊和漏诊2例。结论 64层螺旋CT阴性法胆管成像技术对胆管梗阻病变的定位、定性诊断有较高的价值,可为临床确诊及手术方案的制定提供依据。Objective To evaluate the negative CT cholangiopancreatography （N-CTCP） on diagnosing biliary duct obstruction by using 64 slice CT. Methods 105 patients with obstructive jaundice were diagnosed by the clinicians and then underwent abdominal 64 slice CT including plain and contrast-enhanced scans. All CT data were post-processed by using N-CTCP method including multiplanar reconstruction（MPR）, cured planar reformation（CPR） and minimum Intensity projection （Min IP）. Then the obstructive sites were localized on CT images, and the pathogenic diagnoses were compared with surgery and pathology.Results The obstruction sites of 105 cases were successfully diagnosed on the transverse CT images and N-CTCP reconstruction images, respectively. The positive rate of pathogenic diagnoses based on transverse CT images was 82.9% （87/105）, but based on combination of transverse and N-CTCP reconstruction images it was 93.3%（98/105）. The positive rate of pathogenic diagnoses for benign lesions （n=69） was 85.5%（59/69） based on transverse images and 92.8% （64/69） based on combination of transverse and N-CTCP reconstruction images; for malignant lesions （n=36）, it was 77.8% （28/36） and 94.4%（34/36）, respectively. Conclusion Combined with N-CTCP reconstruction, the pathogenic diagnoses of biliary duct obstruction were improved by using contrast-enhanced 64 slice CT scan.

关 键 词：胆管梗阻 阴性法胆管成像 体层摄影术 X线计算机 

分 类 号：R816.5[医药卫生—放射医学]