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目的 评价双剂量法螺旋CT胆道造影 (SCTC)及三维重建技术的临床应用价值。材料与方法 5 0例临床拟诊胆胰疾病患者用 5 0 %胆影葡胺 40ml加入 5 0 %葡萄糖 60ml滴注 45分钟 ,滴注开始后 60～ 12 0分钟内行螺旋CT扫描 ,图像经 3D最大强度投影 (MIP)及表面遮盖法 (SSD)后处理。结果 血胆红素定量小于 2mg/dl( 3 4 μmol/L) ,胆系显影率为 10 0 % ,小于 68.4μmol/L ,大于3 4 μmol/L ,显影率为 84% ,总显影率为 86%。无 1例过敏反应。SCTC良好显示胆管树 3级以上分支 3 9例 ,胆囊显影 2 4/43例 ,显影率 5 5 %。 3 2例阳性 ,7例正常。与手术病理及临床结果对照诊断正确率为 90 %。结论 初步研究结果表明 ,双剂量法SCTC技术能有效提高胆系显影率 ,可作为肝胆术前及胰胆管疾病诊断 ,血胆红素定量小于 68.4μmol/L患者的一种无创性检查方法。
Objective To evaluate the clinical value of dual-dose spiral CT cholangiography (SCTC) and three-dimensional reconstruction. Materials and Methods Fifty patients with clinically suspected biliary and pancreatic diseases were treated with 60 ml of 50% dextromethorphan 40 ml for 45 minutes and spiral CT 60 to 120 minutes after drip infusion. The image was 3D Maximum intensity projection (MIP) and surface masking (SSD) post-processing. Results Serum bilirubin was less than 2 mg / dl (34 μmol / L). The development rate of biliary line was 100%, less than 68.4 μmol / L, more than 34 μmol / L, the developing rate was 84% 86%. No one allergic reaction. SCTC well showed 39 cases of bile duct tree above grade 3, 24/43 cases of gallbladder development, developing rate of 55%. 32 cases were positive and 7 cases were normal. With the surgical pathology and clinical results of the diagnosis correct rate of 90%. Conclusion The preliminary results show that double-dose SCTC technique can effectively improve the rate of biliary development, which can be used as a noninvasive method for the diagnosis of hepatobiliary and pancreaticobiliary diseases and the quantitative determination of serum bilirubin less than 68.4 μmol / L.