CT对肝外胆管梗阻性质的鉴别诊断  

CT Differential Diagnosis of Extrahepatic Billary Obstruction

作　　者：许相丰[1] 宋宏伟[1] 武广利[1] 

机构地区：[1]天津市南开医院放射科,天津300100

出　　处：《中国中西医结合外科杂志》2003年第5期360-363,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的 :探讨良恶性肝外胆管梗阻病变的CT表现及其诊断意义。 方法 :回顾经手术病理证实的肝外胆管梗阻病变 76例 (良性 34例 ,恶性 4 2例 )。 结果 :肝内胆管呈枯枝状轻中度扩张 ,肝内外胆管不一致扩张 (内轻外重 ) ,肝外胆管远段梗阻 ,梗阻部胆管呈削尖状狭窄 ,肝外胆管壁呈弥漫环形增厚 ,对良性梗阻的诊断有重要意义。肝内胆管呈软藤状重度扩张 ,肝外胆管中段梗阻 ,梗阻部胆管呈伴或不伴肿块的截断型或突然狭窄型 ,肝外胆管壁局限不规则增厚 ,高度揭示恶性梗阻。 结论 :良恶性肝外胆管梗阻病变均有特征性CT表现 。Objective To evaluate some specific signs by analyzing the CT findings of benign and malignant biliary obstruction diseases Methods Preoperative CT findings of 76 cases of pathologically proved extrahepatic biliary obstructive diseases (34 benign and 42 malignant)were reviewed. Results Mild degree of intrahepatic bile duct dilatation as a withered tree and disparate dilation (mild in intrahepatic and marked in exprahepatic)were usually found in benign diseases,and marked degree of dilatation as soft rattans was often seen in malignant lesions.Obstruction of the distal portion of the common bile duct was often seen in benign diseases,and malignant obstruction were often found at the middle portion.The gradual tapering in obstruction segment of the bile duct and the diffuse concentric wall thickening of the common bile duct were more often seen in benign cases,whereas dilated extrahepatic bile duct ending abruptly or narrowing sharply with or without a mass and the focal eccentric wall thickening at the obstructed level were more indicative of malignant diseases. Conclusion CT scan is valuable in the diagnosis of extrahepatic biliary obstruction.Specific signs of CT images were found in either benign or malignant lesions.The nature obstruction can be determined by careful scrutiny of the morphological changes of the bile duct and of clinical material.

关 键 词：CT检查 肝外胆管梗阻 鉴别诊断 良性梗阻 恶性梗阻 

分 类 号：R735.8[医药卫生—肿瘤] R730.44[医药卫生—临床医学]