多层螺旋CT 3D成像联合增强扫描对胆道梗阻性病变的诊断价值  

Diagnostic Value of Multi-slice Spiral CT 3D Imaging Combined with Enhanced Scanning for Biliary Obstructive Lesions

作　　者：蔡振岩 CAI Zhenyan(Medical Imaging Center,the Fourth People’s Hospital of Shangqiu,Shangqiu 476100,China)

机构地区：[1]商丘市第四人民医院医学影像中心,河南商丘476100

出　　处：《河南医学研究》2023年第18期3415-3418,共4页Henan Medical Research

摘　　要：目的 探讨多层螺旋CT 3D成像联合CT增强扫描诊断胆道梗阻性病变的价值。方法 回顾性选取2019年6月至2022年6月在商丘市第四人民医院接受手术治疗的70例胆道梗阻性病变患者的临床资料,所有患者术前均接受多层螺旋CT 3D成像、CT增强扫描检查,以手术病理检查结果为金标准,分析多层螺旋CT 3D成像联合CT增强扫描诊断胆道梗阻性病变的价值。结果 经手术病理检查确诊,70例患者中恶性病变30例(胰头癌12例,壶腹部癌14例,胆管癌4例),良性病变40例(胆道下段结石35例,胆管下段炎症梗阻5例);经Kappa一致性检验,多层螺旋CT 3D成像联合CT增强扫描检查诊断胆道梗阻性病变结果与手术病理结果的一致性极好(Kappa=0.800,P<0.001);多层螺旋CT 3D成像联合CT增强扫描检查敏感度、阴性预测值均高于层螺旋CT 3D成像、CT增强扫描单独检查,且准确度高于CT增强扫描,差异有统计学意义(P<0.05);多层螺旋CT 3D成像联合CT增强扫描检查壶腹部癌检出率高于多层螺旋CT 3D成像、CT增强扫描单独检查,差异有统计学意义(P<0.05)。结论 多层螺旋CT 3D成像联合增强扫描诊断胆道梗阻性病变的效果显著,且可明确其胆道梗阻性病变情况。Objective To explore the value of multi-slice spiral CT 3D imaging combined with enhanced CT scanning in the diagnosis of biliary obstructive lesions.Methods Retrospective selection of clinical data from 70 patients with biliary obstructive lesions who underwent surgical treatment in the Fourth People’s Hospital of Shangqiu from June 2019 to June 2022.All patients underwent multi-slice spiral CT 3D imaging and enhanced CT scanning before surgery.Based on the surgical pathological examination results as the gold standard,the value of multi-slice spiral CT 3D imaging combined with enhanced CT scanning in the diagnosis of biliary obstructive lesions was analyzed.Results Of the 70 cases confirmed by surgery and pathology,30 cases were malignant(12 cases of pancreatic head cancer,14 cases of ampulla cancer,4 cases of cholangiocarcinoma cancer),40 cases were benign(35 cases of lower bile duct stones,5 cases of lower bile duct inflammatory obstruction).According to the Kappa consistency test,the combination of multi-slice spiral CT 3D imaging and enhanced CT scanning in the diagnosis of biliary obstructive lesions showed excellent consistency with surgical pathological results(Kappa=0.800,P<0.001).The sensitivity and negative predictive value of multi-slice spiral CT 3D imaging combined with CT enhanced scanning were higher than those of multi-slice spiral CT 3D imaging and enhanced CT scanning alone,and the accuracy was higher than that of CT enhanced scanning(P<0.05).The detection rate of ampullary cancer using multi-slice spiral CT 3D imaging combined with enhanced CT scanning was higher than that using multi-slice spiral CT 3D imaging and enhanced CT scanning alone(P<0.05).Conclusion The combination of multi-slice spiral CT 3D imaging and enhanced scanning has a significant effect on the diagnosis of biliary obstructive lesions,and can clarify the situation of biliary obstructive lesions.

关 键 词：多层螺旋CT 3D成像 CT增强扫描 胆道梗阻性病变 

分 类 号：R445[医药卫生—影像医学与核医学]