摘要
目的探讨经T管造影螺旋CT胆道成像(spiral CT cholangiography,SCTC)的技术应用及临床价值。方法40例胆道手术患者术后2周经T管注入25%泛影葡胺50 ml行常规胆道造影检查摄片;隔日螺旋CT进行平扫,然后注入5%泛影葡胺50 ml,进行螺旋CT胆道造影,三维重建方法用最大信号强度投影和表面阴影显示法。结果SCTC在显示Ⅲ,Ⅳ级肝管,肝管汇合情况,发现肝内外胆管残石方面均优于T管常规造影(P<0.05)和B超(P<0.05),在发现胆道残石方面与胆道镜检查结果相当,两者差异无统计学意义(P>0.05)。结论经T管造影螺旋CT胆道成像结合常规CT断层像可同时观察胆道内外病变,弥补单纯胆道造影不足。螺旋CT胆道三维成像显示肝内和肝门部胆管立体构像及细节,为外科临床工作提供了实时放射解剖学资料。
Objective To assess the technical points of spiral CT cholangiography （SCTC） by dripping the meglumine diatrizoate into T-tube and its value in clinical applications. Methods Forty cases with the common bile duct exploration take the conventional T-tube cholangiography by dripping 50 ml of 25% meglumine diatrizoate into T-tube after operation for 2 weeks, and run the spiral CT scanning, then run SCTC after dripping 5% meglumine diatrizoate into T-tube. 3-D reconstructed images were maximum intensity projection （MIP） and surface shaded display （SSD）. Results SCTC was better than the T-tube cholangiography （P〈0.05） and B-ultrasound scan （P〈0.05） in demonstrating Ⅲ, IV level of hepatic ducts, the confluence of hepatic ducts, and discovering the remnant stone in the intrahepatic and extrahepatic ducts. In discovering the biliary duct remnant stone, there were no significance differences in the SCTC and choledochoscope （P〉0.05）. Conclusion To observe the images of SCTC by dripping the meglumine diatrizoate into T-tube, CT scan can find the exterior and interior disorder of biliary duct, and overcome some disadvantage of the conventional T-tube cholangiography. 3-D reconstructed images can demonstrate 3-D structures of intrahepatic and the bile ducts of porta hepatis in detail, it offers radiological anatomy data in real time for clinical practice.
出处
《肝胆胰外科杂志》
CAS
2008年第3期171-174,共4页
Journal of Hepatopancreatobiliary Surgery
基金
上海市南汇区医疗卫生资助项目(NKYL0510)
