双源CT胆囊三角区结构探查在胆囊结石合并胆囊炎术前评估中的效能分析  

Analysis on the efficacy of DSCT exploration on the trigone structure of gallbladder in preoperative assessment for cholecystolithiasis complicated with cholecystitis

作　　者：李曼 刘利 浦静洁 毛威威 赵雪文 LI Man;LIU Li;PU Jing-jie(Department of Medical Imaging,Suzhou Ninth People's Hospital,Suzhou 215200,China)

机构地区：[1]苏州市第九人民医院医学影像科,江苏苏州215200

出　　处：《中国医学装备》2023年第10期61-65,共5页China Medical Equipment

基　　金：江苏省医学会伦琴影像科研专项[SYH-3201150-0018(2021013)]“双源CT双能量扫描在腺瘤性胆囊炎息肉与胆固醇性胆囊息肉的鉴别诊断价值”。

摘　　要：目的:探讨双源CT(DSCT)胆囊三角区结构探查在胆囊结石合并胆囊炎术前评估中的价值。方法:选取医院收治的109例胆囊结石合并胆囊炎患者(胆固醇型41例,混合型29例,胆色素型39例)纳入观察组;同时选取经DSCT诊断为非胆囊疾病的80例患者纳入对照组,比较两组患者的胆囊动脉、胆囊管走行情况,分析观察组不同结石成分CT值差异及对结石成分的预测。结果:观察组胆囊动脉、胆囊管不同评分(0分、1分、2分)优于对照组,差异有统计学意义(Z=-2.173,Z=-4.433;P<0.05)。观察组和对照组胆囊动脉正常走行比例分别为93.58%(102/109)和100.00%(80/80),胆囊管正常走行比例分别为94.50%(103/109)和100.00%(80/80),差异均无统计学意义。观察组胆囊动脉异型走行中Ⅰb型3例(占2.75%),Ⅱa型2例(占1.83%),Ⅱb型2例(占1.83%)。观察组中胆固醇型、混合型和胆色素型患者的性别、高血压及糖尿病患者占比,差异均无统计学意义;胆固醇型结石CT值为(60.20±11.28)HU,明显低于混合型和胆色素型结石,差异有统计学意义(F=12.201,P<0.05)。CT值预测胆固醇型结石的受试者工作特征(ROC)曲线下面积为0.915,95%CI为0.858~0.971,截断值为71.84 HU,灵敏度和特异度分别为88.20%和87.80%。结论:在胆囊结石合并胆囊炎中,DSCT胆囊三角区结构探查能够清晰显示胆囊动脉及胆囊管情况,可为术前评估提供可靠依据,对结石成分有一定预测价值。Objective:To explore the value of dual source computed tomography(DSCT)in the preoperative assessment for cholecystolithiasis complicated with cholecystitis.Methods:A total of 109 patients with cholecystolithiasis complicated with cholecystitis who admitted to hospital were selected as the observation group(41 cases were cholesterol type and 29 cases were mixed type in these patients),and 80 patients without gallbladder disease who were diagnosed by DSCT were divided into control group.The situations of the arteries of gallbladder and cystic ducts of two groups were compared.At the same time,the differences of CT values of different stone compositions of the observation group were analyzed,and the stone compositions were predicted.Results:The different scores(0 point,1 point and 2 points)of the artery of gallbladder and cystic ducts of observation group were significantly better than those of control group,with statistical significance(Z=-2.173,Z=-4.433,P<0.05),respectively.The proportion of normal routing of the artery of gallbladder of observation group and control group were respectively 93.58%(102/109)and 100.00%(80/80),and the proportion of normal routing of gallbladder duct were respectively 94.50%(103/109)and 100.00%(80/80),while without statistically significant differences.In the observation group,there were 3 cases of type Ib(2.75%),2 cases of type IIa(1.83%)and 2 cases of type IIb(1.83%)in the routing of abnormal type of the artery of gallbladder.In the observation group,the differences of the proportions of gender,hypertension and diabetes among cholesterol type,mixed type and bilirubin type were not significant.The CT value(60.20±11.28)HU of the stone of cholesterol type was significantly lower than that of the stone of mixed type and the stone of bilirubin type(F=12.201,P<0.05).The area under curve(AUC)of the receiver operating characteristic(ROC)curve of CT value was 0.915 in predicting the stone of cholesterol type,and the 95%CI was 0.858-0.971,and the cut-off value was 71.84 HU,and the sensitivi

关 键 词：胆囊结石 胆囊炎 双源CT(DSCT) 胆囊三角区 

分 类 号：R575.6[医药卫生—消化系统] R816.5[医药卫生—内科学]