螺旋CT图像后处理技术诊断坏疽性胆囊炎的应用价值  

Value of CT imaging post-processing technique in diagnosis of gangrenous Cholecystitis

作　　者：李洪[1] 张海兵[1] 周柱玉[2] 李汝辉[1] 

机构地区：[1]四川省德阳市人民医院放射科,四川德阳618000 [2]四川省德阳市人民医院超声科,四川德阳618000

出　　处：《医学影像学杂志》2016年第9期1645-1648,共4页Journal of Medical Imaging

摘　　要：目的采用螺旋CT多平面重组及最大密度投影技术,探讨坏疽性胆囊炎的CT表现特征。方法收集经手术、病理证实的坏疽性胆囊炎28例,均行64层螺旋CT平扫和双期增强扫描并采用多平面重组技术(MPR)及最大密度投影技术(MIP),分析坏疽性胆囊炎的CT表现特征。结果 1)胆囊增大,平均值5.63cm。胆囊壁水肿增厚,平均值0.5cm。胆囊壁广泛/灶状模糊24例,胆囊周围脓肿12例。合并胆囊结石26例;2)胆囊壁分层状线样强化,轻度强化23例,中度强化5例;3)胆囊动脉存在单支狭窄、闭塞13例。结论胆囊壁增厚,结构模糊,甚至消失,胆囊壁分层样细线样强化,强化幅度差,是坏疽性胆囊炎的CT表现特征。MPR、MIP显示胆囊动脉节段性狭窄、闭塞是诊断坏疽性胆囊炎最有力的佐证。Objective To explore imaging features of gangrenous cholecystitis using CT imaging post-processing technique. Methods Imaging data were reviewed retrospectively in twenty eight patients with gangrenous cholecystitis proved by surgery and pathology. Plain and dual-phase contrast-enhanced CT scans were performed in all patients. Image data were post-reconstructed with MPR and MIP procedure. The imaging manifestations were analyzed. Results 1 ） The gallbladder enlarged with averaged of 5.63 cm in transverse diameter ; 2 ） The wall of gallbladder thickened with average of 0.5 cm in thickness. The wall blurred in part or in whole in twenty four cases （86%）. The abscesses paragallbladder visualized in twelve cases （43%） ; 3） Twenty six cases （93 % ） accompanied with cholecystolithiasis; 4） The wall of gallbladder enhanced with linear border and enhanced mildly in twenty three cases （ 82% ）, while 5 （ 18% ） was enhanced moderately; and 5 ） The artery of gallbladder showed stenosis or oc- clusion in thirteen cases. Conclusion The wall of gallbladder thickened with partly or thoroughly destructed and enhanced mildly with line-like contour are the characteristics of gangrenous cholecystitis. The artery of gallbladder were well visualized with MPR and MIP. The stenosis and occlusion of the gallbladder aided in the diagnosis of gangrenous cholecystitis.

关 键 词：坏疽性胆囊炎 体层摄影术 X线计算机 多平面重组 最大密度投影 

分 类 号：R575.6[医药卫生—消化系统] R814.42[医药卫生—内科学]