低位梗阻性黄疸SCT表现分析

目的分析常见低位梗阻性黄疸病因螺旋CT表现特征,以进一步提高CT对低位梗阻性黄疸病因诊断的准确性.方法分析我院1998年～2004年经手术、病理证实的低位梗阻性黄疸123例,良性梗阻72例,其中胆总管结石60例,胆总管炎性病变12例,恶性梗阻51例,其中胰头癌25例,胆总管癌14例,壶腹癌12例.结果胆总管结石中有52例显示"新月征"或"靶征".胰头癌增强扫描均呈低密度.胆总管癌中有9例见胆总管腔内明显均匀强化的结节.12例壶腹癌中有9例显示十二指肠乳头区充盈缺损,明显强化.良性低位梗阻中肝内胆管和胆总管轻、中度扩张分别为51例和65例,51例肝内胆管呈竹节状扩张,49例肝内、外胆管扩张不成比例;恶性低位梗阻中36例肝内胆管呈软藤状重度扩张,43例肝内、外胆管成比例扩张.结论 SCT扫描在低位梗阻病因的诊断和鉴别诊断中是一种有效而准确的检查方法.

The Analysis of SCT Findings for Low-level Obstructive Jaundice

Objective To analyze the spiral CT findings feather of the common disease causes of low-level obstructive jaundice and to improve the accurate rate of the diagnosis of low-level obstructive jaundice by CT scan.Methods One hundred and twenty three cases of low-level obstructive jaundice proved by surgery or pathology from 1998 July to 2004 February were analyzed.There were 72 cases of benign low-level obstructive jaundice including 60 cases of common bile duct stone and 12 cases of the inflammation of common bile duct.There were 51 cases of low-level malignant obstructive jaundice including 25 cases of the carcinoma of pancreatic head,14 cases of cholangiocarcinoma and 12 cases of ampullary carcinoma.Results There were 52 cases with "new moon sign"or"target sign".The common bile duct of 9 cases became thin gradually among the cases of the inflammation of common bile duct.All cases of the carcinoma of pancreatic head showed lower density after enhancement.Nine cases showed nodules in the common bile ducts with obviously homogenous enhancement.Nine cases of the ampullary carcinoma showed filling defect in the doudenal lumen with obvious enhancement.The common bile duct of 51 cases and the intrahepatic bile duct of 65 cases of benign low-level obstruction were light-degree dilation.The dilated intrahepatic bile duct of 49 cases was unproportional with dilated extrahepatic one.Thirty-six cases of malignant low-level obstruction manifested heavy-degree dilated intrahepatic bile duct which of 43 cases was proportional with extrahepatic one.Conclusion Spiral CT scan is an effective and accurate examination modality in the diagnosis and differential diagnosis of low-level obstructive jaundice.