64层螺旋CT胰胆管及腹腔血管三维成像在胆胰疾病中应用.docVIP

64层螺旋CT胰胆管及腹腔血管三维成像在胆胰疾病中应用 　 作者：方驰华 范应方 朱新勇 项楠 杨剑 全显跃 梁文　 【摘要】 目的 研究64层螺旋CT胰胆管三维成像联合腹腔血管三维成像在胆胰疾病诊治中的应用。方法 对52例胰胆管疾病患者，通过行64层螺旋CT扫描及后期胰胆管、腹腔血管三维成像进行定位、定性诊断，对比分析手术及病理检查结果。结果 46例胰胆管三维成像清晰显示病灶和梗阻远、近端狭窄及扩张的胆管、胰管；联合腹腔血管三维成像可多方位清晰显示结石和肿瘤与周围组织解剖关系。与手术及病理检查结果对比，胰胆管三维成像对胆胰疾病的定位和定性诊断符合率达到98%(45/46)和93%(43/46)，联合腹腔血管三维成像定位、定性诊断符合率均达100%(38/38)；手术可切除性判断准确率为93%(14/15)。结论 64层螺旋CT胰胆管三维成像联合腹腔血管三维成像能获得清晰的胰胆管影像，立体显示胰胆管结构、病灶形态及其与周围组织的解剖关系，提高了胆胰疾病诊断率，为手术提供正确的指导。 【关键词】 64层螺旋CT； 三维成像； 胆胰疾病 【Abstract】 Objective To study the application of threedimensional reconstruction of 64slice spiral CT (64SSCT) cholangiopancreatography and angiography in diagnosis of pancreaticobiliary disease. Methods Fiftytwo patients were performed with 64SSCT scan and then threedimensional reconstructions of cholangiopancreatography and angiography were made to locate and qualitatively diagnose pancreaticobiliary disease. The data obtained from the reconstruction were compared with the surgical and pathological examination results. Results The threedimensional image clearly displayed the focus, stenosis of proximal and distal hepatopancreatic duct and ecstatic pancreaticobiliary duct in 46 patients. Combined with threedimensional reconstruction of angiography, the relationship between calculus or tumor and surrounding tissue was clearly displayed. Compared with the surgical and pathological examination, the accurate rate of threedimensional reconstruction of cholangiopancreatography in located and qualitative diagnosis was 98%(45/46) and 93%(43/46) respectively, and the two indexes reached 100%(38/38) when combined cholangiopancreatography with angiography. The accurate rate of judgment on tumor resection was 93%(14/15). Conclusions Threedimensional reconstruction of 64SSCT cholangiopancreatography and angiography can clearly display the structure of pancreaticobiliary duct, morphosis of focus and its relationship with surrounding tissue, which helps to increase the accurate rate of diagnosis of pan