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1、经T管造影螺旋CT胆道成像的临床价值作者:韩江作者单位:上海市南汇区周浦医院【摘要】耳的探讨经T管造影螺旋CT胆道成spiralCTcholangiography,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50ml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50ml,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(PvO.05)和B超(PvO.05),在发现胆道
2、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)o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。【关键词】体层摄影术X线计算机胆道造影管ClinicalappliedvalueofspiralCTcholangiographyviaT-tubeHANJiang,CHUWenjun,GUOJian,etal.DepartmentofSurgery,ZhoupuHospital,Zho
3、upuShanghai201318AbstractObjectiveToassessthetechnicalpointsofspiralCTcholangiography(SCTC)bydrippingthemegluminediatrizoateintoT^tubeanditsvalueinclinicalapplications.MethodsFortycaseswiththecommonbileductexplorationtaketheconventionalT^tubecholangiographybydripping50mlof
4、25%megluminediatrizoateintoT-tubeafteroperationfor2weeks,andrunthespiralCTscanning,thenrunSCTCafterdripping5%megluminediatrizoateintoTtube.3・Dreconstructedimagesweremaximumintensityprojection(MIP)andsurfaceshadeddisplay(SSD).ResultsSCTCwasbetterthantheT-tubecholangiography
5、(P<0.05)andB-ultrasoundscan(P<0.05)indemonstratingIII,IVlevelofhepaticducts,theconfluenceofhepaticducts,anddiscoveringtheremnantstoneintheintrahepaticandextrahepaticducts・Indiscoveringthebiliaryductremnantstone,therewerenosignificancedifferencesintheSCTCandcholedochoscope(
6、P>0.05).ConclusionToobservetheimagesofSCTCbydrippingthemegluminediatrizoateintoT-tube,CTscancanfindtheexteriorandinteriordisorderofbiliaryduct,andovercomesomedisadvantageoftheconventionalTtubecholangiography.3-Dreconstructedimagescandemonstrate3・Dstructuresofintrahepatican
7、dthebileductsofportahepatisindetail,itoffersradiologicalanatomydatainrealtimeforclinicalpractice.Keywordstomography,X-raycomputed;cholangiography;T-tube静脉注入胆道造影剂进行螺旋CT扫描胆道成像(spiralCTcholangiography,SCTC)是一种较新的技术,国内外报道已应用于胆道疾病的诊断。而直接经T管注入造影剂行SCTC国内外报道较少。我们在胆道手术+T管引流术后40例患者中
8、经T管注入造影剂行SCTC检查,取得初步结果,现报告如下。1资料和方法1」一般资料40例胆道手术+T管引流术后患者。男18例,女22例,年龄42〜82岁,平均56.3岁。胆总管结