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目的 探讨多层面螺旋CT胆道成像技术 (MSCTC)要点及其临床应用价值。材料与方法 19例怀疑胆道梗阻患者 ,从周围静脉滴注 10 %胆影葡胺 10 0ml后 ,60～ 90分钟行上腹部快速容积扫描 ,利用图形工作站的后处理功能行胆道系统的三维重建 ,并将观察结果与原始横断面图像和临床病理进行对照。结果 ( 1) 15例血清胆红素低于 2mg/dl( 3 4 μmol/L)的病例中 14例胆道强化效果良好 ,而 4例血清胆红素高于 2mg/dl的病例中 3例强化效果较差。( 2 )与横断面图像相比 ,三维图像显示胆道梗阻的部位与病因更直观、准确 ,无假阳性和假阴性发生。( 3 )Raysum技术能去除强化胆汁的掩盖 ,更清楚地显示胆道系统的细小病变。结论 MSCTC是一种安全可靠、简便易行的胆道系统无创伤检查技术 ,尤其对血清胆红素低于 2mg/dl的病例有很高的临床应用价值。
Objective To investigate the main points of multi-slice spiral CT imaging and its clinical value. Materials and Methods Nineteen cases of suspected biliary tract obstruction were treated with intravenous infusion of 10% diacetate 10% intravenous bolus, rapid volume scanning of the abdomen was performed from 60 to 90 minutes, and 3D reconstruction of the biliary tract was performed using the post-processing function of the graphic workstation. The results were compared with the original cross-sectional images and clinical pathology. Results (1) Forty of the 15 patients with serum bilirubin less than 2 mg / dl (34 μmol / L) had good biliary tract enhancement and 3 of 4 patients with serum bilirubin higher than 2 mg / dl Less effective (2) compared with the cross-sectional images, the three-dimensional image shows the site of biliary obstruction and cause more direct and accurate, no false positive and false negative occurred. (3) Raysum technology removes the masking of biliary strictures and shows more clearly the small lesions of the biliary system. Conclusion MSCTC is a safe, reliable and easy-to-use technique for the noninvasive examination of the biliary system, especially for cases with serum bilirubin less than 2 mg / dl.