低张CT胆道成像MinIP联合CPR对胆道梗阻的诊断价值

打开文本图片集

[Abstract]Objective：ToexplorethediagnosticvalueofMinIPcombinedwithCPRinlowtensionCTcholangiographyfor biliaryobstruction.Methods：Atotalof21Opatientswhowereclinicallsuspectedbiliaryobstructivediseaseandunderwent CTcholangiographywereprospectivelyselectedastheresearchsubjects.Allpatientswererandomlydividedintotheroutine group（Group A）andthelowtensiongroups（GroupB1andGroupB2）usingarandom number table，with7O patients in each group.GroupAunderwent CTunder normaltension，andtheimages were post-processed withMPR.GroupB1andB2 werescannedafterfilingtheduodenumbydrinkingwaterseveraltimesindiferentstagesunderlowtension，andtheimages ofGroupB1werepost-processedwith MPR，whiletheimagesofGroupB2werepost-procesedwith MinIPand CPR.All imageswereanalyzed，thelocationandqualitativediagnosisofbiliaryobstructionhadbenmade，thediagnosticvalueswere comparedamong thethreegroups.Results：Comparedtotheacuracyof locationdiagnosisforbiliaryobstructionamong the threegroups，GroupB2hadthe highestaccuracyof97.14%（68/70），folowed byGroup B1of 84.29%（59/70），andGroup A hadthelowestaccuracyof 65.71%（46/70）.Thequalitative diagnosticacuraciesin GroupB1andB2were91.43%（64/70） and95.71%（67/70），respectively，which were higher than the accuracy of 77.14%（54/70）in GroupA（both P<0.05 ）. The positivepredictivevalueof GroupB1，thenegativepredictivevalueandsensitivityof GroupB2were96.55%（28/29）， 97.73%（43/44）and 96.00%（24/25），respectively，which were all higher than those in Group A（all P <0.05）.Compared to surgicalpathologyorERCPfindings，GroupB1andB2hadtheexcellntdiagnosticconsistency（K=0.826，0907）hileGroup A had the moderate consistency （ K=0.529 ）.Conclusions：Compared to conventional methods，MinIP combined with CPR in lowtensionCTcholangiographycansignificantlyimprovethelocationandquaitativediagnosisforbiliaryobstructionandhas ahigher clinical value.

[Keywords]Tomography，X-raycomputed;Lowtension；Minimumintensityprojection;Curveplanereformation；Biliary obstruction;Diagnosis

临床上胆道梗阻病因复杂多样，可因胆管结石、炎症、肿瘤及其他病变引起，而不同病变导致的临床表现又有重叠，给诊断带来困难[1-2]。（剩余6680字）