摘要
目的探讨影像检查对胆囊内瘘的诊断价值。方法回顾性分析34例经手术病理证实胆囊内瘘的多层螺旋CT（MSCT）、磁共振（MRI）、磁共振胰胆管造影（MRCP）资料,结合文献分析其影像特征。结果 34例胆囊内瘘中内瘘部位有37个,其中3例有2个不同部位内瘘,其中胆囊十二指肠瘘22个,胆囊胃窦瘘5个,胆囊结肠瘘10个,合并Mirizzi综合征5例。MSCT、MRI、MRCP直接显示胆囊内瘘瘘口30例,瘘口33个（89.19%）,胆囊结石24例（70.59%）,萎缩性胆囊炎23例（67.65%）,胆管结石22例（64.71%）,胆囊积气17例（50%）,胆管积气17例（50%）,胆囊与周围脏器粘连34例（100%）,既往胆囊结石消失或异位出现及结石性肠梗阻2例（5.88%）。结论胆囊内瘘的直接征象是胆囊与周围脏器的瘘口,间接征象是萎缩性胆囊炎、胆囊结石、胆管结石、胆管积气、胆囊积气、胆囊与相邻脏器粘连、既往胆囊结石消失或异位出现及伴胆石性肠梗阻。
Objective To study the diagnostic values of imaging examination in internal gallbladder fistula. Methods Thirty-four patients of internal gallbladder proved by pathology were examined with imaging examination. The findings of multi-slice spiral CT（ MSCT）,magnetic resonangce imaging（ MRI）,magnetic resonance cholangiopancreatography（ MRCP）were retrospectively analyzed together with review of the literature. Results There are 37 fistulae in 34 internal gallbladder fistula cases,three of which have two different locations of the fistulae. There are 22 gallbladder duodenal fistulas,5 gallbladder gastric fistulas,10 gallbladder colon fistulas in 34 cases,combined with Mirizzi syndrome in 5 cases. MSCT,MRI and MRCP directly displayed 33（ 89. 19%） internal gallbladder fistula in 30 cases,gallbladder stones in 24 cases（ 70. 59%）,atrophic cholecystitis in 23 cases（ 67. 65%）,bile duct stones in 22 cases（ 64. 71%）,gallbladder gas accumulation in 17 cases（ 50%）,bile duct gas accumulation in 17 cases（ 50%）,gallbladder and the surrounding organs adhered together in 34 cases（ 100%）,previously disappeared or ectopic gallbladder stones and gallstone ileus in 2 cases（ 5. 88%）.Conclusion The direct signs of internal gallbladder fistula is the fistula between gallbladder with the surrounding organs,indirect signs are atrophic cholecystitis,gallstones,bile duct stones,bile duct gas accumulation,gallbladder gas accumulation,adhesion between gallbladder and the surrounding organs,previous disappeared or ectopic gallbladder stones and gallstone ileus.
作者
史凤霞
刘建滨
郭一清
SHI Fengxia;LIU Jianbin;GUO Yiqing(The People＇s Hospital of Hunan Province, Changsha,Hunan Province 410005 ,P. R. China)
出处
《临床放射学杂志》
CSCD
北大核心
2018年第3期424-427,共4页
Journal of Clinical Radiology
关键词
多层螺旋CT
磁共振
磁共振胰胆管造影
胆囊内瘘
Multi-slice spiral CT Magnetic resonance imaging Magnetic resonance cholangio-pancreatography Internal galloladder fistula
