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目的：分析梗阻性黄疸的ＣＴ表现，探讨螺旋ＣＴ在鉴别诊断中的作用。材料与方法：对经手术、病理证实的梗阻性黄疸６２例进行螺旋ＣＴ、 ＥＲＣＰ＋螺旋ＣＴ联合检查。结果：肝内胆管呈枯枝状扩张多见于胆总管结石（２４／２８）少数可见于肿瘤性病变（３／２８）；呈软藤状扩张，胆管壁见软组织肿块为肿瘤性病变。但不能区分良恶性。病因诊断符合率Ｂ超７３％、螺旋ＣＴ ８７％、ＥＲＣＰ＋螺旋ＣＴ联合检查１００％。结论：梗阻性黄疸良恶性鉴别需结合临床和ＣＴ征象综合分析。螺旋ＣＴ、 ＥＲＣＰ＋螺旋 ＣＴ联合检查是鉴别诊断十分有效的方法。
Objective: To analyze the CT features of obstructive jaundice and to explore the role of spiral CT in differential diagnosis. Materials and Methods: Surgical and pathological examinations of 62 cases of obstructive jaundice were performed by spiral CT and ERCP + spiral CT. Results: Intrahepatic bile duct showed a branching dilation mostly seen in common bile duct stones (24/28). A few were found in tumorous lesions (3/28); it showed soft cane-like dilation; bile duct wall seen soft tissue mass was a tumorous lesion. However, it cannot distinguish between benign and malignant. The etiological diagnosis coincidence rate was 73% for B-ultrasound, 87% for spiral CT, and 100% for ERCP + spiral CT. Conclusion: The differentiation of benign and malignant obstructive jaundice needs to be combined with clinical and CT signs. Spiral CT, ERCP + spiral CT joint examination is a very effective method of differential diagnosis.