论文部分内容阅读
目的 :探讨对阻塞性黄疸更精确的影像学诊断方法。方法 :对 45名怀疑有阻塞性黄疸的病人 ,行常规ER CP检查 ,退镜后立即进行螺旋CT扫描。将螺旋CT三维成像显示胆管阻塞的原因、位置和程度与ERCP的检查结果相比较。结果 :45名病人中 ,螺旋CT胆管造影显示了 30名病人有胆管阻塞 ,没有假阳性或假阴性病例。胆管阻塞的原因有 :胆管结石 2 4例、胆管癌 3例、胆管狭窄 3例。ERCP与螺旋CT胆管造影均能对 2 4例胆管结石的位置、大小作出正确评价。对 2名胆管癌的病人 ,螺旋CT胆管造影描绘了未显影的部位 ,而ERCP却未能作到。螺旋CT胆管造影未能对 1名病人的胆管狭窄长度作出正确评价。ERCP对 2名病人肝内胆管狭窄有更清晰的诊断。结论 :ERCP结合螺旋CT三维成像对怀疑有阻塞性黄疸病人的胆管系统可作出正确评价。
Objective: To explore a more accurate method of imaging diagnosis of obstructive jaundice. Methods: Forty-five patients with suspected obstructive jaundice underwent routine ERCP examination. Spiral CT scanning was performed immediately after the procedure. The spiral CT three-dimensional imaging shows the cause, location and degree of biliary obstruction compared with the ERCP test results. RESULTS: Of the 45 patients, spiral CT cholangiography showed obstruction of the bile duct in 30 patients, with no false-positive or false-negative cases. The causes of obstruction of bile duct are: 24 cases of bile duct stones, 3 cases of cholangiocarcinoma, 3 cases of biliary stricture. Both ERCP and spiral CT cholangiography can correctly evaluate the location and size of 24 cases of bile duct stones. For two patients with cholangiocarcinoma, spiral CT cholangiography undeveloped sites, whereas ERCP failed to do so. Spiral CT cholangiography failed to correct the length of bile duct stenosis in a patient. ERCP on the two patients with intrahepatic bile duct stenosis have a more clear diagnosis. Conclusion: ERCP combined with spiral CT three-dimensional imaging can be correctly evaluated in patients with obstructive jaundice.