摘要
本文对８２例手术病理证实的阻塞性黄疸作前瞻性ＣＴ诊断，并与直接胆道造影比较研究。发现胆管逐渐尖削、明显的肝外胆管壁环状增厚是良性阻塞可靠且特异的ＣＴ征象；肝内外胆管不一致扩张（内轻外重）、扩张胆管腔内ＣＴ值大于２０ＨＵ对良性阻塞的判断有一定帮助。胆管突然中断伴或不伴肿块、胆管壁局限不规则增厚是恶性阻塞相对可靠且特异的ＣＴ征象。ＣＴ能清楚显示肝内胆管扩张及它们汇合处解剖及变异，比较直接胆管造影，ＣＴ对肝门阻塞的估价更容易、全面、可靠。ＣＴ对阻塞的定位、定性有与直接胆管造影同样高的准确性，但ＣＴ还能对恶性胆道阻塞的手术切除可行性作出相当可靠的估价。
Eighty two cases with obstructive jaundice proved by operation and pathology were prospectively diagnosed by CT, and compared with direct cholangiography(DC). The smooth tapering in obstructive segement of bile duct and the marked concentric wall thickening of extrahepatic bile ducts were the typical and specific CT findings for determining of benign obstruction. Disparate dilatation(marked in extrahepatic, mild in intrahepatic bile ducts) and CT value higher than 20HU within the dilated ducts were helpful for determining of benign obstruction. The abrupt termination of dilated bile duct with or without a mass and the focal eccentric wall thickening of bile ducts were the relatively typical and specific CT findings for determining of malignant obstruction. CT was capable of clearly showing the dilatation of intrahepatic radicals and the anatomy of their confluence and congenital abnormalities. Hilar obstruction was evaluated by CT more easily ,correctly and reliable than by DC. The accuracy of CT predicting of the level and cau se of biliary obstruction was the same as that of DC However,CT can correctly evaluate the resectability of malignant obstruction.
出处
《临床放射学杂志》
CSCD
北大核心
1994年第4期224-228,共5页
Journal of Clinical Radiology
关键词
CT
胆管阻塞
造影
诊断
Biliary obstruction Computed tomography
