经窦道造影判断螺旋CT观察胆道引流术后T管窦道的可行性研究  

Trans-sinus radiography for assessment the feasibility of spiral CT in diagnosis of T-tube for sinus formation after biliary drainage

作　　者：汪建初[1] 浦涧[1] 王存川[2] 路远[1] 卓臣义[1] 吴贤建[1] 马日海[1] 陆玉敏[3] 

机构地区：[1]右江民族医学院附属医院肝胆外科,广西百色533000 [2]暨南大学微创外科研究所,广东广州510630 [3]右江民族医学院附属医院医学影像科,广西百色533000

出　　处：《右江民族医学院学报》2015年第2期185-187,共3页Journal of Youjiang Medical University for Nationalities

基　　金：广西壮族自治区卫生厅立项课题(Z2012719)

摘　　要：目的：探讨128排螺旋 CT 对胆道引流术后 T 管窦道观察的准确性。方法前瞻性搜集我院2011年5~12月我科行胆道手术后 T 管引流病人共120例,常规术后14 d 行螺旋 CT 检查,观察窦道是否形成。在进行 T 管造影同时通过 T 管旁另插小管进行窦道造影,观察窦道形成情况。以窦道造影无造影剂外漏为诊断窦道形成完整的金标准,观察螺旋 CT 对胆道引流术后 T 管窦道观察的准确性。结果120例病人中,CT 判断窦道形成者有90例,窦道未形成者占30例,经过窦道造影,90例 CT 证实窦道完整的病例窦道均完整,另30例窦道不完整者中,经过窦道造影,有28例发现窦道不完整,有造影剂自 T 管周围漏出,有2例窦道造影显示无造影剂漏出。CT 检查窦道完整性的灵敏度达到97.83%（90/92）；特异性达100%（28/28）；阳性预测值为100%（90/90）；阴性预测值为93.33%（28/30）。结论螺旋CT 可以观察 T 管窦道形成情况,为拔除 T 管前检查窦道的形成提供影像学依据。Objective To evaluate the accuracy of 128-row helical CT in scanning and diagnosing the for-mation of T tube sinus tract after biliary drainage. Methods The materials of 120 patients who underwent the T tube drainage after the biliary tract operation from May 201 1 to December 201 1 in our hospital were pro-spectively collected.The spiral CT scanning was performed 14 days after the operation to observe whether the sinus tract was formed.Sinus tract radiography was performed to observe the formation of the sinus tract through a small tube inserted near the T-tube when T-tube radiography was carried out.The diagnosed cri-teria was whether the contrast media extravasation existed for judging the accuracy of CT in diagnosing the T-tube sinus tract formation. Results In 120 patients,after the judgment by CT,90 cases had sinus tracts for-mation,while 30 cases had unformed sinus tracts.The complete sinus tracts of the 90 cases which were con-firmed by CT were all complete proven by sinus tract angiography,while in another 30 cases found to be in-complete by CT,28 cases of them were found by the sinus tract angiography to be incomplete with the leakage of contrast agents around the T tube,and the sinus tract angiography of the other 2 cases showed no contrast a-gent leaking.The sensitivity of CT in examining the integrity of the sinus tract reached up to 97.83% （90/92）;the specificity reached up to 100% （28/28）;the positive predictive value was 100% （90/90）;the negative pre-dictive value was 93.33% （28/30）. Conclusion The spiral CT can be used to observe the formation of T tube sinus tract,which provides an imaging evidence for examining the formation of sinus tract before the removal of T tube.

关 键 词：胆总管探查 T 管引流术 T 管窦道 窦道造影 体层摄影术 螺旋计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学]