分泌性CT胆管造影及其临床应用

随着多排螺旋CT的迅猛发展以及碘化胆管对比剂的不断升级,分泌性CT胆管造影的临床应用价值有了显著提高.本文对分泌性CT胆管造影的发展历史、检查方法、三维重建技术、临床应用价值、碘化胆管对比剂的发展史、对比剂的常见副反应等进行了综合性的回顾和探讨.作为有创性检查ERCP和PTC的替代和补充,分泌性CT胆管造影具有安全、简单、无创、检查时间相对较短、胆系充盈效果好等特点.CT胆管造影可为肝胆外科手术,腹腔镜手术、肝移植手术和介入治疗等制定手术计划,评估手术风险提供重要的影像学参考,展现出广阔的临床应用前景.

CT Cholangiography

CT cholangiography has significantly evolved in recent years. Modern multi-detector CT scanners are capable of acquiring single breath hold contiguous scans at submillimeter spatial resolution, which lend themselves to multiplanar and three-dimensional (3D) reconstruction. CT cholangiography involves the use of ionizing radiation and administration of biliary contrast agents with a small risk for adverse reactions. CT cholangiography provides some functional information about hepatocyte excretion, and, if there is normal excretion, affords excellent depiction of small, nondilated peripheral biliary radicles. This review provides an overview of the CT cholangiography currently available to the clinician. We provide a brief history and some clinical practise of CT cholangiography, including most commonly used contrast agents, the adverse reactions of most commonly used iodinated biliary contrast agents, the relation between cholangiography and serum bilirubin, the examination technique, image analysis and the suggested indications of CT cholangiography in symptomatic patients. And they are followed by a detailed discussion of CT cholangiography in modern-day. CT cholangiography in context with hepatic surgery and intervention and preoperative IV CT cholangiography in potential liver donors are also discussed in this review.