目的　探讨CT低张增强扫描在诊断胆总管壶腹癌中的应用价值。方法　回顾分析 15例胆总管壶腹癌 ,其中男 9例 ,女 6例 ,年龄 49～ 71岁 ,平均年龄 5 5岁 ,全部病例均经手术病理证实。采用低张、饮水、增强进行扫描。扫描范围包括右膈顶至十二指肠水平段。结果　全部病例均有肝内外胆管扩张 ,肝内胆管扩张呈软藤状。 9例胰头钩突平面可见“双管征” ,5例可见“双环征” ,3例可见“半月征” ,8例在扩张的十二指肠降段可见乳头状软组织结节影。结论　低张CT增强扫描在胆总管壶腹癌的诊断和鉴别诊断中很有价值。 Objective To investigate the value of enhanced low-contrast CT in the diagnosis of ampullary carcinoma of the common bile duct. Methods A retrospective analysis of 15 cases of common bile duct cancer of the ampulla, including 9 males and 6 females, aged 49 to 71 years, mean age 5 5 years old, all cases were confirmed by surgical pathology. Use low, water, enhanced scan. Scan range includes the right diaphragm top to duodenal horizontal section. Results All patients had intrahepatic and extrahepatic bile duct dilatation, intrahepatic bile duct dilatation was soft rattan. In 9 cases, the “double tube sign” was observed on the plane of the uncinate process of the head of pancreas. The “double ring sign” was seen in 5 cases and “half moon sign” in 3 cases. The nodular papillary soft tissue nodules were seen in the descending segment of the duodenum in 8 cases. Conclusion Low-contrast CT enhanced scan is valuable in the diagnosis and differential diagnosis of ampullary carcinoma of the common bile duct.