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Volume CT Negative Cholangiography Imaging Application Research in the Biliary Obstructive Track Diseases

Author: WuJun
Tutor: WuZhiFeng
School: Shanxi Medical
Course: Medical Imaging and Nuclear Medicine
Keywords: Biliary obstruction Volume CT N-CTC MRCP
CLC: R816.5
Type: Master's thesis
Year: 2013
Downloads: 6
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Abstract


[Purpose] Through the analysis of the imaging characteristics of benign and malignant biliary obstructive disease, discussed the negative CT cholangiography imaging(N-CTC) in the diagnosis of biliary obstruction localization, the qualitative values, for N-CTC provides a reliable theoretical basis for the clinical application.[Materials and methods] Collect47patients with biliary obstruction in July2008to December2012clinical surgical pathology confirmed or approved by ERCP biopsy pathology.29cases were male,18female patients,ages12to87years old,average59.6years. All patients with jaundice,of which34cases of painless jaundice,11cases of abdominal pain associated with jaundice,pain but not with jaundice in2cases.Jaundice1day to2weeks time,the details are shown in table1.All cases of gastrointestinal preparation,in which30cases were filled with water to the digestive tract,17cases positive oral contrast medium filling the digestive tract,requirements in10to20minutes to drink1000ml,intramuscular infection of6-542injection10mg at the same time,10minutes after64-slice helical CT scan and enhanced scan,and all of the original image into three-dimensional restructure Vitea2.0workstations,N-CTC images are acquired using the portal venous phase images,according to the need for coronal,sagittal and inclined plane reconstruction and reorganization of surface images and so on,all restructuring image layer thickness of lmm, reconstruction of the interval is0.5mm.In47cases,25patients underwent MRCP,and then by two diagnosis high qualification doctor according to the original axial images,3-D reconstruction of N-CTC image and MRCP images in localization and qualitative diagnosis of obstruction and compared with postoperative pathology and ERCP diagnosis. Calculation of N-CTC,the accuracy of MRCP in diagnosis of biliary obstructive disease sensitivity, specific and about the Youden index.[Results]64-slice helical CT N-CTC can clearly display the characteristic of benign and malignant obstrucitive disease.In47patients with biliary obstruction:64-slice helical CT N-CTC and MRCP for benign and malignant obstruction localization diagnostic accuracy was100%.N-CTC qualitative diagnosis of benign and malignant obstruction sensitivity and speciality rate was82.4%(14/17) and86.7(26/30),about an Youden index was0.691. And MRCP qualitative diagnosis of binign and malignant obstruction sensitivity and speciality rate was83.3%(5/6)and94.7%(18/19),about the Youden index was0.78.[Conclusion]64-slice helical CT N-CTC is a simple, non invasive examination, clinical application of convenient and feasible, combined with cross-sectional images can be displayed around the bile duct anatomic structure and relations with neighbors, clearly showing the CT features of benign and malignant biliary obstructive disease, visual display bile duct lesions, localization and qualitative diagnosis of biliary obstruction are important value.

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CLC: > Medicine, health > Of Medical > Radiation Medicine > Each location and course of disease X - ray diagnosis and therapy > Stomach and digestive
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