胆囊炎与肝病性胆囊改变在MSCT中的表现  

The Manifestation of Cholecystitis and Hepatic Gallbladder Changes in Multi-Slice Spiral CT

作　　者：唐文浩 赵宇靖 孙文玥 TANG Wen-hao;ZHAO Yu-jing;SUN Wen-yue(Department of Imaging,Shanghai Dermatology Hospital,Shanghai 200443,China)

机构地区：[1]上海市皮肤病医院影像科,上海200443

出　　处：《中国CT和MRI杂志》2021年第2期102-104,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨胆囊炎与肝病性胆囊改变在多排螺旋CT(MSCT)中的表现。方法选取我院2015年3月至2018年3月收治的胆囊炎患者50例,肝病性胆囊患者49例。所有患者均进行MSCT平扫及双期增强扫描。观察两组患者在MSCT中的不同表现,并比较两组患者在多排螺旋CT中囊壁厚径及不同表现差异。结果胆囊炎组胆囊轮廓模糊为90.00%,胆囊壁厚度平均为(4.74±1.21)mm,38.88%合并结石,46.00%合并有条状高密度影,30.00%合并胆汁密度增高,16%出现邻近肝组织动脉期一过强化,10.00%出现胆囊周围积液。肝病性胆囊组胆囊轮廓模糊为26.53%,胆囊壁厚度平均为(3.74±0.77)mm,81.63%出现脾脏增大,61.22%出现侧支循环,6.12%出现胆汁密度增高,28.57%出现胆囊周围积液。胆囊炎组患者胆囊壁平均厚径明显厚于肝病性胆囊组(P<0.05)。两组患者在邻近肝组织一过性强化、胆囊周围积液及形态、胆汁密度增高、囊壁强化及轮廓清楚度及与周围结构粘连方面比较差异有统计学意义(P<0.05)。结论多排螺旋CT在胆囊炎与肝病性胆囊的鉴别诊断中具有较高的价值,值得临床推广应用。Objective To investigate cholecystitis manifestations and hepatic gallbladder changes in multi-slice spiral CT.Methods 50 patients with cholecystitis and 49 patients with hepatic gallbladder were selected from March 2015 to March 2018.All patients underwent a dual-phase enhanced scan and multi-slice spiral CT plain scan.Observe the different manifestations of the two groups of patients in multi-slice spiral CT,and compare the differences in the thickness and diameter of the cyst wall and the different manifestations of the two groups of patients multi-slice spiral CT.Results In the cholecystitis group,90.00%of the gallbladder contour was blurred,and the average thickness of the gallbladder wall was(4.74±1.21)mm.38.88%of the patients were complicated with stones,46.00%with strip high-density shadow,30.00%with increased bile density,16%with transient enhancement in arterial phase of adjacent liver tissue,and 10.00%with peri gallbladder effusion.The average thickness of the gallbladder wall was(3.74±0.77)mm.81.63%of them had splenomegaly,61.22%had collateral circulation,6.12%had increased bile density,and 28.57%had perigallbladder effusion.The average thickness of the gallbladder wall in the cholecystitis group was significantly thicker than that in the hepatic gallbladder group(P<0.05).There were significant differences between the two groups in transient enhancement of adjacent liver tissue,peri gallbladder effusion,and morphology,increased bile density,enhancement of cystic wall and contour clarity,and adhesion with surrounding structures(P<0.05).Conclusion Multi-slice spiral CT has a high value in the differential diagnosis of cholecystitis and hepatic gallbladder,and it is worthy of clinical application.

关 键 词：胆囊炎 肝病性胆囊 多排螺旋CT 鉴别诊断 

分 类 号：R575.61[医药卫生—消化系统] R445.3[医药卫生—内科学]