胆系疾病的ct诊断PPT.ppt

胆系疾病的CT诊断; 一 胆道的CT检查方法 ;2 扫描方法; 口服胆囊造影CT扫描：于口服碘番酸0.5g后15h行CT扫描。胆囊收缩功能正常者，可见胆囊内充盈造影剂。对显示阴性结石及胆囊息肉等有很好的增强效果 。 ;;CT表现;胆固醇结石;;胆色素结石;;;混合性结石;;;;胆管结石：胆总管结石有以下CT表现;;;;CT表现;;;; CT未见明确结石影，拟为胆囊分隔或折叠畸形、胆囊炎 ;MRI示胆囊扭曲变形，其内见充满小结石影；MRCP薄层尚显示胆总管下段两枚小结石影;CT未见阳性结石影 ，仅见胆囊体积增大;MRI清晰显示胆囊内充盈缺损，见七枚小结石影 ;CT示胆囊炎，未见结石影；MRI示胆囊底部多发小结石并胆总管中、下段结石;CT示胆囊单发结石；MRI显示胆囊内多发大小不等、信号不一的结石影 ;CT示胆总管扩张、胆管炎；MRI见胆总管内多发充盈缺损结石影;胆道炎症性疾病 ; 总述;病理;临床表现;CT表现;;胆囊结石并胆囊炎;;急性胆囊炎并胆囊周围脓肿;急性胆囊炎并胆囊周围脓肿;出血性胆囊炎;气肿性胆囊炎;慢性胆囊炎 ;病理;临床表现。 ; CT表现;慢性胆囊炎;慢性胆囊炎;慢性胆囊炎;慢性胆囊炎并胆囊壁钙化;胆道恶性肿瘤 ; 病理表现;临床表现; CT表现;;其他表现;;;;胆囊癌，胆囊腔内型;胆囊癌，胆囊壁增厚型;胆囊癌，胆囊壁浸润型;胆囊癌，胆囊腔内型;胆囊癌，肿块型;胆囊癌，肿块型，侵犯肝脏;胆管癌 ;;;;;;;;;先天性胆管囊肿 ;;;;; Ⅲ型：小囊时，CT诊断有一定困难。大囊时表现为突入十二指肠肠腔内或壁内的囊肿，其余胆道部分无异常征象。 Ⅳ型：表现为肝内胆管及肝外胆管的囊状扩张或肝外胆管的多发囊状扩张。 V型：肝内多发大小不等囊状低密度病变，并与扩张的胆管相通。静脉注射胆影葡胺以后，可见扩张的胆管及囊肿内有造影剂充盈，与多发性肝囊肿之不同。 ;;;梗阻性黄疸的cT诊断 ; 1 肝门区胆道梗阻; 2肝总管梗阻; 3胆总管梗阻; 4壶腹部梗阻;问题:;--+++++++++++++++---+-+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++