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目的探讨64层CT阴性法胰胆管成像(N-CTCP)对胆道梗阻部位、范围、性质的诊断价值。方法2005年10月至2006年3月对临床诊断为梗阻性黄疸的14例病人行64层CT腹部增强扫描后进行表面阴影(SSD)、容积重建(VR)、多平面重建(MPR)、曲面平展(CPR)、最大密度投影(MIP)、间接最小密度投影(Imi-nIP),以及SSD+VR、MPR/曲面平展+MIP、thin-slab+MIP/VR重建。对该技术在判断胆道梗阻平面、梗阻性质以及胆管显示能力方面进行评价。结果N-CTCP图像质量优良。在细小胆管显示能力上,N-CTCP的MinIP重建逊于MRCP,但N-CTCP的SSD+VR重建效果与MRCP相当。对梗阻性质的诊断准确率N-CTCP为100%(14/14)。结论N-CTCP成像操作简单、快速,且较MRCP经济,可三维地显示胰胆管解剖结构及其周边器官、血管情况。其图像质量、显示细小胆管能力和对梗阻的诊断价值接近MRCP,具有较好的临床应用价值。
Objective To investigate the diagnostic value of 64-slice CT-negative cholangiopancreatography (N-CTCP) for the location, range and nature of biliary obstruction. Methods From October 2005 to March 2006, 14 cases of obstructive jaundice were diagnosed as obstructive jaundice, and underwent 64-slice CT abdomen enhancement scan. The images of surface shadow (SSD), volume reconstruction (VR), multiplanar reconstruction (MPR) (CPR), maximum density projection (MIP), indirect minimum density projection (Imi-nIP), and SSD + VR, MPR / MIP, thin-slab + MIP / VR reconstruction. The technique was evaluated in terms of determining the level of biliary obstruction, the nature of obstruction and the ability of the bile ducts to display. Results N-CTCP image quality is good. Minipore reconstruction of N-CTCP is inferior to that of MRCP in displaying the small bile ducts, but SSD-VR reconstruction of N-CTCP is equivalent to that of MRCP. The diagnostic accuracy of obstructive nature of N-CTCP was 100% (14/14). Conclusion N-CTCP imaging is simple, rapid and economical compared with MRCP. The anatomical structure of pancreaticobiliary duct and its peripheral organs and blood vessels can be displayed three-dimensionally. Its image quality, showing the ability of small bile duct and the diagnosis of obstruction close to MRCP, has good clinical value.