Department of Radiology, Harvard Medical School and Massachusetts General Hospital, Boston, MA 02114, USA.
Radiographics. 2009 Nov;29(7):2059-80. doi: 10.1148/rg.297095051.
Infectious cholangitides encompass a wide spectrum of infectious processes affecting the biliary tree. They can have protean clinical and imaging appearances. Some manifest as an acute medical emergency with high mortality if not properly and emergently managed. Others are chronic processes that may predispose a patient to liver failure or cholangiocarcinoma. The clinical and imaging features and the subsequent therapy are dictated by the pathogens involved, the immune status of the host, and the degree and distribution of biliary obstruction. Bacteria cause most cases of infectious cholangitis in Western countries. In other parts of the world, parasites play an important role, either as causative agents or in predisposing the host to bacterial superinfection. Viral cholangitides primarily affect immunocompromised patients. The clinical and imaging features of cholangitis differ between immunocompetent and immunocompromised patients. Imaging plays a pivotal role in diagnosis of infectious cholangitis, helps identify predisposing causes, and demonstrates complications. Moreover, interventional radiology provides tools to treat acute life-threatening biliary infections, chronic entities, and complications.
传染性胆管炎包括一系列影响胆道的感染性疾病。它们可能具有多变的临床和影像学表现。如果不能及时、紧急地进行适当处理，一些疾病会迅速发展为危及生命的急性医学急症。另一些则是慢性疾病，可能导致患者肝功能衰竭或胆管癌。病原体、宿主的免疫状态以及胆道梗阻的程度和分布决定了临床和影像学特征以及随后的治疗方法。在西方国家，细菌引起大多数传染性胆管炎病例。在世界其他地区，寄生虫起着重要作用，无论是作为病原体还是使宿主易发生细菌继发感染。病毒性胆管炎主要影响免疫功能低下的患者。免疫功能正常和免疫功能低下患者的胆管炎临床和影像学特征不同。影像学在诊断传染性胆管炎、确定易患病因和显示并发症方面发挥着关键作用。此外，介入放射学为治疗急性危及生命的胆道感染、慢性病变和并发症提供了工具。
