【摘要】 目的　评价PTC对成人先天性胆管囊肿的诊断价值。方法　收集 15例经B超、PTC检查疑患先天性胆管囊肿的患者 ,部分CT检查。全部经手术和病理证实。结果　按Todani五分法手术证实 ( 1) 1型 :肝外胆管囊肿 10例 ,表现为肝外胆管呈漏斗状或梭形扩张。 ( 2 ) 4型 :3例。表现为肝内外胆管多发梭形或柱状扩张 ,胆胰共同管过长 ,大于 10mm。 ( 3) 5型 :即Caroli氏病 2例 ,表现为肝叶内胆管多发大小不一囊状或“分节状”扩张。CT表现肝内多发大小不一囊状或“分节状”低密度灶 ,增强无强化 ,有中心点征。合并肝硬化 ,门脉高压。 15例均伴有胆管炎和胆囊炎 ,12例有胆管结石。本组CT、B超、PTC诊断正确率分别为 91.7%、83.3 %、10 0 %。结论　成人先天性胆管囊肿伴有许多并发症 ,给CT、B超诊断增加难度 ,而PTC有利于对胆管的整体显示 ,包括病变的部位 ,范围 ,准确诊断及分型 ,极有助于临床更多还原

【Abstract】 Objective To evaluate the diagnostic value of PTC for congenital choledochol cyst in adult. Methods 15 cases of congenital choledochol cyst were revealed by Bmode US and PTC with some of CT scans; including 6 males, 9 females with age of 16-58 years averaging on 32. All of the cases were confirmed surgically and pathologically. Results The 15 surgically proven cases were categorized by Todani Five Division Method into (1) Type 1:10 cases of extrahepatic choledochol cyst manifested with funnel or spindle shaped dilatation of extrahepatic bile ducts. (2) Type 4:3 cases showed multiple spindle or columnal shaped dilatations of intra and extrahepatic bile ducts with over 10mm elongation of the common pancreatic bile duct. (3) Type 5: 2 cases of Caroli’s disease appeared as intrahepatic multiple cystic or “segmental” low density lesions of different sizes with no enhancement on CT postcontrast scans but having central spot sign, oftenly complicated by cirrhosis and portohypertension. All 15 cases were featured by cholangitis and cholecystitis including formation of gallstones in 12 cases. The diagnostic accuracy rates of CT, Bmode US and PTC were 91.7%, 83.3% and 100%, respectively. Conclusions Congenital choledochol cyst in adult associated with many complications provides high diagnostic difficulties for CT and Bmode US but PTC can show the complete biliary tree beneficial clinically for planning surgery.更多还原