64层螺旋ct胰胆管和腹腔血管三维成像在胆胰疾病中的应用

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1、64层螺旋CT胰胆管和腹腔血管三维成像在胆胰疾病中的应用作者：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

2、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】ObjectiveTostudytheapplicationofthree10

3、dimensionalreconstructionof64slicespiralCT(64SSCT)cholangiopancreatographyandangiographyindiagnosisofpancreaticobiliarydisease.MethodsFiftytwopatientswereperformedwith64SSCTscanandthenthreedimensionalreconstructionsofcholangiopancreatographyandan

4、giographyweremadetolocateandqualitativelydiagnosepancreaticobiliarydisease.Thedataobtainedfromthereconstructionwerecomparedwiththesurgicalandpathologicalexaminationresults.ResultsThethreedimensionalimageclearlydisplayedthefocus,stenosisofproximalanddi

5、stalhepatopancreaticductandecstaticpancreaticobiliaryductin46patients.Combinedwiththreedimensionalreconstructionofangiography,therelationshipbetweencalculusortumorandsurroundingtissuewasclearlydisplayed.Comparedwiththesurgicalandpathologicalexaminatio

6、n,theaccuraterateofthreedimensionalreconstructionofcholangiopancreatographyinlocatedandqualitativediagnosiswas98%(45/46)and93%(43/46)respectively,andthetwoindexesreached100%(38/38)whencombinedcholangiopancreatographywithangiography.Theaccuraterateofju

7、dgmentontumorresectionwas93%(14/15).ConclusionsThreedimensionalreconstructionof64SSCTcholangiopancreatographyandangiographycanclearlydisplay10thestructureofpancreaticobiliaryduct,morphosisoffocusanditsrelationshipwithsurroundingtissue,whichhelpstoinc

8、reasetheaccuraterateofdiagnosisofpancreaticobiliarydiseasesandprovideguidancetooperation.【Keywords】64slicespiralCT;Threedimensionalimaging;Pancreaticobiliarydisease胆胰疾病术前定位、定性诊断及判定病变与周围组织的解剖关系，对制定手术方案十分重要。随着多层螺旋CT的临床应用、三维重建技术的完善，螺旋CT胰