摘要
目的评价多层螺旋CT(MSCT)平扫和三期动态增强扫描对壶腹周围病变所致梗阻性黄疸的诊断价值。方法回顾性分析经手术、病理证实的96例梗阻性黄疸患者的MSCT,US,ERCP资料,着重分析MSCT的平扫和三期动态增强扫描在梗阻定位、定性方面的作用及其在良恶性病变鉴别诊断中的作用。结果本组96例梗阻性黄疸患者中,34例胰头区病变MSCT确诊31例,确诊率89.2%,明显高于US(76.4%),54例胆总管末端病变MSCT确诊48例,确诊率87.5%,明显高于US(63.4%),8例十二指肠乳头病变MSCT确诊5例,确诊率62.5%。本组患者MSCT对梗阻的定位诊断均与手术、内镜所见相符,准确率为100%。结论MSCT作为无创性检查技术,可明确判定梗阻部位,平扫和动态增强扫描结合可显著提高良恶性病变鉴别诊断正确率。
Objective To evaluate the diagnostic value of 64-detector row spiral computed tomography （MSCT）scans without and with dynamic enhancement for malignant and benign lesions in the ampullary region.Methods Ninety-six patients with surgically and pathologically proved obstructive jaundice which was induced by periampullary lesions underwent MSCT,color Doppler uhrasonography （CDUS）,of whom,4 patients underwent additional ERCP,and then the roles of MSCT scans before and after triphasic-dynamic enhance- ment in the qualitative and locative diagnoses of obstructive jaundice and in the differential diagnoses of malignant from benign lesions were emphatically analyzed.Results Among 96 cases of obstructive jaundice,MSCT correctly diagnosed 89.2% of patients （31/36） with pancreatic head lesions（〉76.4% of CDUS）,87.5% of patients （48/54） with common bile duet lesions（〉63.4% of CDUS）,and 62.5% of patients （5/8）with duodenal papilla lesions.The locative diagnosis of MSCT for obstructive part in the group was corresponding to intraoperative and endoscopic findings,the accuracy was 100%.Conclusion As a noninvasive imaging teehnique,MSCT can definitely identify the obstructive parts,while the integration of CT plain scan and dynamic-enhanced scan can significantly elevate the accuracy of differential diagnosis between malignant and benign lesions.
出处
《实用医学影像杂志》
2009年第2期89-91,共3页
Journal of Practical Medical Imaging
