摘要
目的探讨肝吸虫所致胆道梗阻的CT表现特点,提高对该病的认识,避免漏诊、误诊。方法搜集经病理证实的14例肝吸虫所致胆道梗阻患者的临床及CT检查资料,进行回顾性分析。结果肝吸虫胆道梗阻CT表现为梗阻部位胆道壁均匀增厚、延迟强化,管壁厚度为(1. 94±0. 07) mm,狭窄段长度为(14. 27±5. 29) mm,边缘光整。肝内外胆管轻、中度扩张,肝包膜下小胆管"囊状、杵状"扩张。胆管扩张程度与黄疸分度、直接胆红素、胆总管狭窄段内径等的相关性均有统计学意义。结论肝吸虫所致胆道梗阻是临床上的少见疾病,胆管壁均匀增厚、较长的狭窄段、肝内外胆管轻、中度扩张并末梢小胆管"囊状、杵状"扩张等CT征象有助于肝吸虫所致胆道梗阻的诊断。
Objective We studied the CT features of biliary obstruction caused by liver fluke,in order to raise awareness of the disease and avoid missed diagnosis or misdiagnosis when we encounter this disease. Methods We collected the clinical and CT examination data of 14 patients which were diagnosed by pathology as clonorchisis biliary obstruction,and then conducted a retrospective analysis of this data. Results Uniform thickening of bile duct wall with delayed enhancement were observed on obstruction site. The thickness of bile duct wall was( 1. 94 ± 0. 07) mm,length of the narrow segment was( 14. 27 ± 5. 29) mm with smooth edge. Intrahepatic and extrahepatic bile duct had mild or moderate dilatation.The small biliary ducts of the subcapsular liver were dilated as'sac-like or clubbed'shadow. There was statistically significant correlation between the dilatation level of bile ducts and the degree of jaundice. There also was statistically significant correlation between the dilatation level of bile duct and direct bilirubin. On the other hand,the correlation between the dilatation level of the bile duct and the internal diameter of stenosed segment of common bile duct was statistically significant.Conclusion Biliary obstruction of liver fluke is a rare clinical disease. These CT signs such as uniform thickening of bile duct wall、elongated narrow segment、intrahepatic and extrahepatic bile duct mild and moderate dilatation with dilatation of subcapsular bile duct as'sac-like or clubbed',and so on will contribute to the diagnosis of biliary obstruction caused by liver fluke.
作者
陆力坚
黄璐
LU Lijian;HUANG Lu(Department of Infectious Diseases,The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi Zhuang Autonomous Region 530021,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2019年第1期101-104,共4页
Journal of Clinical Radiology
