Miyazaki A, Hirao K, Iwamoto S, Fukuda T, Hayashi K
Department of Radiology, Sasebo Chuo Hospital.
Nihon Igaku Hoshasen Gakkai Zasshi. 1998 Oct;58(12):692-9.
To evaluate the usefulness of helical CT cholangiography (DIC-CT) for laparoscopic cholecystectomy.
Prior to laparoscopic cholecystectomy, 151 patients were examined by DIC-CT. DIC-CT was performed 30 minutes after drip infusion of 100 ml of Iotroxic acid meglumine. Two-dimensional axial (2D) images with 2.5 mm or 1.5 mm slice thickness were reformatted from the raw data, and three-dimensional (3D) images were reconstructed using the surface reconstruction method. Two- and three-dimensional images were compared with the operative cholangiograms in all subjects.
DIC-CT images of 16 cases of aberrant bile duct (10.6%) and 4 cases of anomalous junction of the cystic duct (2.6%) corresponded to the operative cholangiogram. In one case of an aberrant posterior bile duct, which drained into the common bile duct more proximally to the papilla Vater than the cystic duct did, it was difficult to diagnose correctly the anomalous junction of the bile duct on 2D images but easy on 3D images. Although another case was misdiagnosed to have double cystic ducts on 3D images, the 2D images and operative cholangiogram showed normal junction of a cystic duct.
Both 2D and 3D images were useful and necessary in the evaluation of anomalous bile ducts before laparoscopic cholecystectomy.
评估螺旋CT胆管造影术（数字成像与通信医学CT，DIC-CT）在腹腔镜胆囊切除术中的应用价值。
151例患者在腹腔镜胆囊切除术前行DIC-CT检查。在静脉滴注100ml碘海醇葡甲胺30分钟后进行DIC-CT检查。从原始数据中重建层厚为2.5mm或1.5mm的二维轴向（2D）图像，并使用表面重建方法重建三维（3D）图像。将所有受试者的二维和三维图像与术中胆管造影图像进行比较。
16例（10.6%）胆管变异和4例（2.6%）胆囊管异常汇合的DIC-CT图像与术中胆管造影图像相符。在1例后位胆管变异病例中，该胆管汇入胆总管的位置比胆囊管更靠近十二指肠乳头，二维图像难以正确诊断胆管异常汇合，但三维图像则较容易。虽然另1例在三维图像上被误诊为双胆囊管，但二维图像和术中胆管造影显示胆囊管汇合正常。
二维和三维图像在腹腔镜胆囊切除术前行胆管异常评估中均有用且必要。
