中国实用外科杂志

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肝胆管结石影像学诊断技术选择及评价

任    克,张    鑫   

  1. 中国医科大学附属第一医院放射科,辽宁沈阳110001
  • 出版日期:2016-03-01 发布日期:2016-03-01

  • Online:2016-03-01 Published:2016-03-01

摘要:

彩超检查是肝胆管结石常用的初步检查方法,适用于结石的筛查。CT平扫可诊断高密度结石,难以发现等密度结石。CT增强扫描结合CT平扫可发现多数肝胆管结石,并且可显示结石引起的肝内并发症,如肝脓肿和肝内胆管细胞癌。MRI平扫可显示肝内胆管结石,也可显示结石远端的肝内胆管扩张,有助于发现肝脏内的异常信号病变,MRI增强的价值在于发现肝脓肿、胆管细胞癌等肝内病变,对于胆管炎症和肿瘤也有一定的诊断价值。磁共振胰胆管造影(MRCP)的价值在于显示胆管树,显示梗阻的部位,MRCP诊断肝总管及胆总管病变应结合CT或MRI增强扫描。

关键词: 肝胆管结石, 彩色超声, X线计算机断层摄影, 磁共振成像

Abstract:

Selection and evaluation of different imaging technology for hepatolithiasis        REN Ke,ZHANG Xin. Department of Radiology, the First Hospital of China Medical University,Shenyang110001,China
Corresponding author:REN Ke,E-mail:renke815@sina.com
Abstract    Color ultrasound is a common examination method,suitable for the screening of stones. CT plain scan can diagnose high density stones,difficult to find isodense stones.Enhanced CT can find most stones of hepatic bile duct and the complications,such as liver abscess and intrahepatic cholangiocarcinoma.Plain MRI can display the stones in bile duct and the dilation of the distal duct.It’s helpful to find the abnormal signal in liver.Enhanced MRI can find intrahepatic lesions,such as liver abscess and intrahepatic cholangiocarcinoma,and also has some diagnosis value for the inflammation and tumor of bile duct. MRCP can display the biliary tree and the obstruction site,while have to combine with enhanced CT or MRI in the diagnosis of common hepatic duct and common bile duct lesions.

Key words: hepatolithiasis, color Doppler ultrasound, X-ray computed tomography, magnetic resonance imaging