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The Value of MSCT and Target Scan in the Etiological Diagnosis of Bile Duct Obstruction

Author: WangHongXia
Tutor: ZhangPeiGong；QinDongJing
School: Binzhou Medical College,
Course: Medical Imaging and Nuclear Medicine
Keywords: MSCT Target sweep Common bile duct obstruction Etiological diagnosis
CLC: R816.5
Type: Master's thesis
Year: 2010
Downloads: 8
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Abstract

CT imaging, the purpose of the use of MSCT and target scanning technology to explore its value in the diagnosis of the cause of common bile duct obstruction lesions comprehensive analysis of a variety of lesions for clinical differential diagnosis of benign and malignant lesions of obstruction and stems from a different organizational structure, treatment to provide accurate information. Materials and methods CT examination and confirmed by pathology or clinical diagnosis of 69 patients in our hospital because of obstructive jaundice. The conventional gastrointestinal ready, GE LightSpeed ??64-slice spiral CT machine first abdominal plain site of obstruction of the common bile duct, and then according to the unenhanced images for target scanning, scanning the central area of ??the common bile duct obstruction lesion, last three enhanced scanning, image transmitted the GE AW4.3 workstation for various reconstruction and measurement. According to the signs of lesions display characteristics of various imaging techniques; lesions in all patients divided into benign and malignant obstruction, surgical pathology or clinical diagnosis, analysis of lesion localization and characterization diagnosis rate as well as benign and malignant lesions of the soft tissue mass display situation, common bile duct obstruction morphology, lesion degree of enhancement, biliopancreatic duct dilatation comparison, application SPSS16.0 statistical software related data using χ2 test, χ2 continuity correction testing and other methods, statistically. Setting the inspection level (P = 0.05). Results 1) 69 cases of patients with obstructive routine CT scan and target scan showed lesions of 53 cases each; the conventional unenhanced lesion uniform density of the 29 cases, the uneven 24 cases, the target scanning were 27, 26 cases, the two groups P gt ; 0.05, no significant difference; conventional unenhanced lesion boundary was clear outline of 36 cases, less clear for the 17 cases, the target were 47,6 scan, group P-lt; 0.05 CT targeted scan shows lesion boundary and contour than conventional flat sweep. 2) 69 patients with obstructive cases, CT Ping sweep axial images show lesion in 53 cases, 16 cases of suspicious lesions, unenhanced reconstructed image respectively 59,10 cases, CT scan axial images plus unenhanced reconstruction images showed lesions capacity was not statistically significant. 3) 69 patients with obstructive cases three enhanced scan axial images show lesions and 59 cases of suspicious lesions and 10 cases, enhanced scan horizontal axis plus the reconstructed image shows the lesions were 67 cases of suspicious lesions for the two cases, the two groups P lt; 0.05, enhanced scan horizontal axis bit plus the reconstructed image shows lesions was significantly higher than the probability of enhanced scan axial images. 4) benign common bile duct obstruction positioning and qualitative diagnostic rate of 100% (31/31), 93.5% (29/31); the malignant obstruction positioning and qualitative diagnostic rate of 100% (38/38), 97.4% (37/38). The two sets of qualitative diagnostic rate compared, P gt; 0.05, the difference was not statistically significant. 5) 69 cases of obstruction cases, 16 cases of bile duct cancer by CT diagnosed 15 cases, 1 case was misdiagnosed as inflammation; 3 cases of duodenal papillitis associated with gland hyperplasia, consider ampullary cancer except gland hyperplasia, 2 cases misdiagnosed as ampullary cancer; 12 patients with ampullary cancer, pancreatic cancer, patients with hilar cholangiocarcinoma and bile duct stones, 19 cases of common bile duct stones, 8 cases of biliary inflammatory lesions, 12 cases refers to the recurrence of colorectal cancer invading the common bile duct, 2 cases of retroperitoneal lymph node metastasis invasion and common bile duct and 1 case of congenital choledochectasia make a correct diagnosis. Among them, the common bile duct involvement change the 10 cases, cauliflower change eight cases of the 23 cases, circular or semi-circular nodular change. Three cases of tumor and vascular invasion, intrahepatic metastasis with hilar lymph node metastasis cases, five cases of abdominal and retroperitoneal lymph node metastasis. 6) benign and malignant obstruction cases, soft tissue mass were 3,36 cases. Group P-lt; 0.05, show the rate of malignant bile duct obstruction in patients with soft-tissue mass was significantly higher than in patients with benign obstructive. 7) cases of benign obstruction in the common bile duct suddenly obstruction and progressive obstruction were 23,8; the malignant obstructive respectively 35,3 cases. The two sets of common bile duct obstruction morphology compared to P gt; 0.05, no significant difference. 8) cases of benign obstruction in the common bile duct remarkable expansion and a remarkable expansion of 8, 23 cases; 11, 27 cases of malignant obstruction cases. P gt; 0.05, the two groups showed no significant difference. 9) benign and malignant obstruction cases of \Two sets of p lt; 0.05, in the cases of malignant obstructive benign obstructive cases significantly higher than the probability of double duct sign \Conclusion MSCT combined target scan can clearly show the imaging findings of the site of obstruction of the common bile duct, favor the diagnosis of the cause of the disease and the differential diagnosis of benign and malignant obstruction of the clinical development of treatment programs and assessment of prognosis is important for the diagnosis of this group of diseases. effective screening method.

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