Eracleous Eleni, Genagritis Marios, Papanikolaou Nicos, Kontou Allayioti Maria, Prassopoullos P, Chrysikopoulos Haris, Allan Paul, Gourtsoyiannis Nicholas
Department of Radiology, Diagnostic Center of Ayios Therissos, Nicosia, Cyprus.
Eur Radiol. 2005 Oct;15(10):2130-9. doi: 10.1007/s00330-005-2809-7. Epub 2005 Jun 8.
To explore the potential role of computed tomographic cholangiography (CTC) in relation to magnetic resonance cholangiography (MRC) in cases in which knowledge of biliary kinetics and functional information are important for therapeutic decisions, 31 patients (14 men and 17 women) underwent MRC followed by CTC. We examined nine post-cholecystectomy cases with right upper quadrant abdominal pain, six cases with a previous biliary-enteric anastomosis and clinical evidence of cholangitis, eight biliary strictures with pain or symptoms of cholangitis, four cases with strong clinical evidence of sclerosing cholangitis, three cases with suspected post-laparoscopic cholecystectomy bile leakage, and one case with chronic pancreatitis and a common bile duct stent associated with cholangitis. In relation to MRC, CTC provided additional biliary functional information as follows: abnormal biliary drainage through the ampulla in 7/9 cholecystectomy cases, impaired drainage in 3/6 biliary-enteric anastomoses, and complete obstruction in 2/8 biliary strictures. CTC diagnosed early sclerosing cholangitis in 4/4 cases and confirmed suspected bile leakage in 1/3 post-laparoscopic cholecystectomy patients, and the patency of the biliary stent in the patient with chronic pancreatitis. Thus, CTC provides clinically important information about the function and kinetics of bile and complements findings obtained by MRC.
为了探讨在胆道动力学和功能信息对治疗决策至关重要的病例中,计算机断层扫描胆管造影(CTC)相对于磁共振胆管造影(MRC)的潜在作用,31例患者(14例男性和17例女性)先接受了MRC检查,随后进行了CTC检查。我们检查了9例胆囊切除术后右上腹疼痛的病例、6例既往有胆肠吻合术且有胆管炎临床证据的病例、8例有疼痛或胆管炎症状的胆管狭窄病例、4例有硬化性胆管炎有力临床证据的病例、3例疑似腹腔镜胆囊切除术后胆漏的病例以及1例慢性胰腺炎合并胆管炎且有胆总管支架的病例。与MRC相比,CTC提供了以下额外的胆道功能信息:9例胆囊切除病例中有7例通过壶腹的胆道引流异常,6例胆肠吻合病例中有3例引流受损,8例胆管狭窄病例中有2例完全梗阻。CTC在4/4例病例中诊断出早期硬化性胆管炎,在1/3例腹腔镜胆囊切除术后患者中证实了疑似胆漏,并确定了慢性胰腺炎患者胆管支架的通畅情况。因此,CTC提供了有关胆汁功能和动力学的重要临床信息,并补充了MRC获得的结果。