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目的 :评价ERCP后多层螺旋CT扫描 (简称ERCP后MSCT)与平扫、双期扫描对梗阻性黄疸病因的诊断价值。方法 :回顾性分析 76例经临床确诊为阻塞性黄疸的患者资料 ,其中ERCP后MSCT2 8例 ,平扫 13例 ,双期增强扫描 2 7例 ,平扫 +双期增强扫描 8例。检查方法 :采用螺旋模式扫描 ,重建层厚 2 .5～ 5mm ,ERCP后MSCT拔管后 1～ 2h进行。双期扫描注射造影剂为 80～ 10 0ml,速度为 2 .0～ 3.0ml/s,注药后 30s、80s扫描。观察指标包括 :①胆管扩张程度 ;②管壁清晰度 ;③扩张胆管全貌的显示。结果 :3种扫描技术总的管壁显示情况以ERCP后CT扫描最佳。ERCP后MSCT可进行多种三维重建 ,较好显示胆管内结节。结论 :ERCP后MSCT更适合显示沿人体纵向走行的细小胆管。建议采用 2 .5mm层厚显示胰胆管病变。
PURPOSE: To evaluate the diagnostic value of post-ERCP multi-slice spiral CT (post-ERCP post-MSCT) and plain scan and double-phase scan in the etiology of obstructive jaundice. Methods: A retrospective analysis of 76 cases of clinically diagnosed as obstructive jaundice data, including 8 cases of post-ERCP MSCT2, 13 cases of plain scan, double-phase enhanced scan 27 cases, plain scan + double enhanced scan in 8 cases. Inspection methods: Spiral mode scanning, reconstructed layer thickness 2.5 ~ 5mm, after ERCP MSCT extubation 1 ~ 2h. Two-phase scanning injection contrast agent 80 ~ 10 0ml, speed 2.0 ~ 3.0ml / s, injection 30s, 80s scan. Observations include: ① extent of bile duct expansion; ② wall clarity; ③ expansion of the overall picture of the bile duct. Results: The total wall of the three kinds of scanning technique showed the best CT scan after ERCP. Post-ERCP MSCT can be a variety of three-dimensional reconstruction, better show bile duct nodules. CONCLUSIONS: MSCT is better suited for displaying small bile ducts running longitudinally along the human body after ERCP. Proposed use of 2.5 mm thick pancreaticobiliary duct disease display.