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作者收集经手术证实的胆管结石39例,对其CT征象和诊断进行了分析。大多数患者具有上腹痛、发热和黄疸。全部病例行CT检查,部分病例行B超、ERCP和PTC。CT的直接征象:肝内胆管结石表现为高密度影或软组织密度影(20/23);肝外胆管结石表现为靶征或胰头高密度影(14/24)。间接征象表现为肝内胆管扩张,肝外胆管结石还表现为胆总管扩张。下端逐渐变细。作者认为胆管结石的CT诊断应依据直接征象,参考间接征象,综合提出诊断。本文还对胆管结石的影象诊断方法进行了讨论。
The authors collected 39 cases of choledocholithiasis confirmed by surgery and analyzed their CT signs and diagnosis. Most patients have epigastric pain, fever and jaundice. CT examinations were performed in all cases, and B-ultrasound, ERCP, and PTC were performed in some cases. Direct signs of CT: Intrahepatic bile duct stones show high-density or soft-tissue density (20/23); extrahepatic bile duct stones appear as target signs or high-density pancreatic head shadows (14/24). Indirect signs manifest as intrahepatic bile duct dilatation. Extrahepatic bile duct stones also show dilatation of the common bile duct. The lower end is tapered. The authors believe that CT diagnosis of bile duct stones should be based on direct signs, refer to indirect signs, and comprehensively propose diagnosis. This article also discusses the diagnostic methods of cholelithiasis.