摘要
目的探讨CT及MRI诊断急性胆囊炎的临床价值。方法回顾性分析我院2008年1～5月确诊为急性胆囊炎并行CT或MRI检查且资料完整的21例患者的资料。其中11例行多排螺旋CT平扫和双期增强扫描,10例行MRI多序列多期动态增强扫描。结果急性胆囊炎的主要影像征象包括:胆囊轮廓模糊不清19例(90.5%);胆囊壁均匀增厚15例(71.4%),胆囊壁不均匀增厚6例(28.6%);不同程度的胆囊壁强化21例(100%);胆汁密度增高或T1信号增高11例(52.4%);胆囊周围游离性积液10例(47.6%);胆囊周围粘连或脂肪肿胀16例(76.2%);胆囊床邻近肝组织出现动脉期一过性片状强化16例(76.2%);合并胸水和(或)腹水12例(57.1%);胆囊穿孔并腹膜炎、胆囊腔积气和囊壁小脓肿以及胆囊憩室各1例。结论胆囊轮廓模糊不清、胆囊周围粘连或脂肪肿胀、胆囊床邻近肝组织出现动脉期一过性片状强化等征象诊断急性胆囊炎价值较高,CT及MRI多期增强扫描有助于急性胆囊炎的早期诊断和并发症的发现。
Objective To investigate the diagnostic value of CT scanning and MR imaging on acute cholecystitis. Methods The CT or MR imaging data of 21 patients with proved acute choleeystitis were retrospectively reviewed. Eleven patients were examined with contrast-enhanced multi-detector-row spiral CT scanning and other 10 cases underwent contrast enhanced MR imaging. Results Nineteen patients showed obscure gallbladder outlines （90.5 % ）. The gallbladder wall demonstrated even thickening in 15 patients （71.4 % ） and irregular thickening in 6 cases （28.6 % ）. All patients showed inhomogeneous enhancement of the gallbladder wall （100 % ）. The bile was hyper-dense or hyper-intense on T1W image in 11 cases （52. 4%）. Ten cases had free peri-cholecystic effusion （47.6 % ）, and 16 cases had peri-choleeystic adhesive changes or fat swelling （76.2 %）. Patchy or linear like transient enhancement of the adjacent hepatic bed in the arterial phase was seen in 16 cases （76.2 % ）. Twelve patients de veloped pleural effusion, or ascites, or both （57.1% ）. Gallbladder perforation complicated with peritonitis was seen in one case, micro-abscess formation and pneumocholecystitis was observed in another case, and one case had gall bladder diverticulum. Conclusion Wall blurring, pericholecystic adhesion or fat edema, and transient enhancement of adjacent hepatic bed in the arterial phase are the imaging findings specifically associated with acute cholecystitis, which are readily appreciated on contrast-enhanced multi-phasic CT and MR scanning.
出处
《中国普外基础与临床杂志》
CAS
2008年第9期699-703,共5页
Chinese Journal of Bases and Clinics In General Surgery
关键词
急性胆囊炎
计算机体层摄影
磁共振成像
Acute cholecystitis Computed tomography Magnetic resonance image
