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目的探讨多层螺旋CT(MSCT)的左前斜冠位最小密度投影(MinIP)联合曲面重组(CPR)胆道成像在肝门部胆管癌诊断及分型中的应用价值。资料与方法21例拟诊为肝门部胆管癌患者,行胆管左前斜冠位MinIP+CPR,对肝门部周围结构和胆管壁的显示效果及定性、分型符合率进行评价。结果 18例显示肝门区不规则形或类圆形软组织密度肿块,多呈缓慢延迟强化;3例仅表现为胆管壁不规则增厚,偏心性狭窄或闭塞,肝内胆管呈梗阻性扩张。21例中,3例肝左叶萎缩,4例邻近肝实质受侵犯,形成软组织肿块,6例合并胆道系统结石。对照手术病理结果,MSCT胆道成像定性符合率为100.0%,分型符合率为95.2%,准确率高于常规轴位图像。结论 MSCT左前斜冠位MinIP+CPR胆道成像对肝门部胆管癌的诊断及分型具有重要价值。
Objective To investigate the value of MinIP combined with curved surface reconstruction (CPR) cholangiography in the diagnosis and classification of hilar cholangiocarcinoma by MSCT. Materials and Methods Twenty-one cases of patients with hilar cholangiocarcinoma who were diagnosed as hilar cholangiocarcinoma underwent MinIP + CPR in the left anterior oblique coronary biliary duct. The results were consistent with those of the peri-hepatic portal structures and bile duct wall. Results 18 cases showed hepatic portal irregular or oval soft tissue density mass, mostly slow delayed enhancement; 3 cases showed only irregular thickening of the bile duct wall, eccentric stenosis or occlusion, intrahepatic bile duct obstruction expansion. In 21 cases, 3 cases of left lobe of the liver atrophy, 4 cases of adjacent liver parenchyma violations, the formation of soft tissue mass, 6 cases with biliary system stones. According to the pathological results, the coincidence rate of MSCT biliary tract imaging was 100.0%, and the coincidence rate was 95.2%. The accuracy was higher than that of conventional axial images. Conclusion MSCT left anterior oblique position MinIP + CPR biliary imaging of hilar cholangiocarcinoma diagnosis and classification of great value.