Mironov S P, Akopian V G, Murieva Z D, Tumanian G T, Mironova E S
Med Radiol (Mosk). 1984 Jul;29(7):20-3.
A cyst of the common bile duct, the most frequent variant of cystic dilatation of the extrahepatic biliary tract, presents a serious diagnostic problem. Using serial scintigraphy with 99mTc-HIDA 13 children with cysts of the common bile duct confirmed by the results of operative cholangiography, were examined. In 8 of them a radionuclide study was performed at varying times after operation (cyst extirpation with the establishing of hepatoenteroanastomosis--4 patients, and variants of internal drainage operations--4 patients). Typical scintigraphic signs were the following: sacculated or spheroidal dilatation of the common bile duct in combination with dilatation of the left (7), right (1) or both lobular bile ducts, absence of the gall bladder visualization. In the first 15 min of examination in large size cysts zones of the lowered accumulation of the radiopharmaceutical agent were revealed in the area of the portal fissure. Indicators of absorptive-excretory hepatic function changed mainly in children with spheroid-shaped cysts demonstrating alongside with the time of intestinal visualization the degree of disorder of permeability of the choledoch distal parts. The recovery of the anatomic-functional state of the biliferous system occurred earlier (up to 1.5 year) in children after cyst extirpation than after internal drainage operations. It manifested itself in returning the diameter of the bile ducts to normal and in the improvement of absorptive-excretory hepatic function.
胆总管囊肿是肝外胆道囊性扩张最常见的类型，它带来了严重的诊断难题。对13例经手术胆管造影证实患有胆总管囊肿的儿童进行了99mTc-HIDA连续闪烁扫描检查。其中8例在术后不同时间进行了放射性核素研究（囊肿切除并建立肝肠吻合术——4例，内引流手术的不同术式——4例）。典型的闪烁扫描征象如下：胆总管呈囊状或球状扩张，同时左（7例）、右（1例）或双侧叶胆管扩张，胆囊不显影。在检查的最初15分钟内，大囊肿在门静脉裂隙区域显示放射性药物积聚降低的区域。吸收排泄肝功能指标主要在球形囊肿患儿中发生变化，随着肠道显影时间显示胆总管远端部分通透性紊乱的程度。胆总管囊肿切除术后儿童的胆系解剖功能状态恢复（至1.5年）比内引流手术后更早。其表现为胆管直径恢复正常以及吸收排泄肝功能改善。
