64层螺旋CT对慢性胆囊炎与胆囊癌的鉴别诊断分析

薛少军，任莉

（陕西省汉中市勉县医院，陕西 汉中，724200）

浏览次数：163次 下载次数：319次

摘要：

目的 探讨采用64层螺旋CT在对慢性胆囊炎及胆囊癌疾病鉴别中的临床价值。方法 通过对2013年4月至2016年4月我院收治的360例慢性胆囊炎患者及74例胆囊癌患者进行CT诊断监测，结合CT诊断资料观察胆囊壁情况、胆囊黏膜线的完整性及胆道梗堵情况等以判断胆囊病变情况。结果 CT对厚壁型胆囊癌的灵敏度为91.9%，特异度为97.2%。慢性胆囊炎患者胆囊轮廓清晰307例，胆囊轮廓模糊,41例，胆囊周围见弧形低密度水肿11例，胆囊与肝脏界限不清1例；胆囊癌患 者胆囊轮廓清晰10例，胆囊轮廓模糊51例，胆囊与肝脏界限不清13例；仅61例厚壁型胆囊癌患者发生邻近侵犯及转 移。结论 采用64层螺旋CT对慢性胆囊炎与胆囊癌进行临床鉴别，确诊率高，误诊率低，具有很高的应用价值。

关键词：64层螺旋CT；慢性胆囊炎；胆囊癌；诊断价值

中图分类号：R735.8文献标志码：A文章编号：2096-1413(2017)07-0132-02

The differential diagnosis of chronic cholecystitis and gallbladder carcinoma

with 64 slice spiral CT
XUE Shao-jun, REN Li
(the Hospital of Mian County, Hanzhong 724200, China)

ABSTRACT: Objective To investigate the clinical value of 64 slice spiral CT in the differential diagnosis of chronic cholecystitis and gallbladder carcinoma. Methods Three hundred and sixty cases of patients with chronic cholecystitis and 74 cases of patients with gallbladder cancer in our hospital from April 2013 to April 2016 were selected and all the patients were diagnosed with CT monitoring. Combined with the CT diagnostic data, the situation of gallbladder wall, integrity of the gallbladder mucosal line and biliary obstruction were observed and to determine the pathological changes of gallbladder. Results The sensitivity and specificity of CT in the diagnosis of thick-wall gallbladder carcinoma were 91.9% and 97.2%. In the chronic cholecystitis patients, 307 cases with clear outline of gallbladder, 41 cases with vague outline of the gallbladder, 11 cases with low density edema around the gallbladder, 1 case with unclear boundary between gallbladder and liver. In gallbladder carcinoma patients, 10 cases with clear outline of gallbladder, 51 cases with vague outline of the gallbladder, 13 cases with unclear boundary between gallbladder and liver, 61 cases thick -wall gallbladder carcinoma patients with adjacent invasion and metastasis. Conclusion 64 slice spiral CT in the diagnosis of chronic cholecystitis and gallbladder can obtain high diagnosis rate, with low misdiagnosis rate, it has high application value.
KEYWORDS: 64 slice spiral CT; chronic cholecystitis; gallbladder carcinoma; diagnosis value

参考文献：
[1] 俞羚,韩雪盈.GE16排CT在胆囊癌诊断中的应用价值[J].世界最新医学信息文摘:连续型电子期刊,2014,14(25):194.
[2] 陶云年,张文奇,王善军,等.螺旋CT在胆囊癌诊断中的价值[J].医学影像学杂志,2014,24(1):89-92.
[3] 杜富会,张安,周怀琪.胆囊癌的影像学诊断[J].医用放射技术杂志, 2006,14(2):100-102.
[4] 郎宁,刘剑羽,王永进,等.多排螺旋CT鉴别诊断黄色肉芽肿性胆囊炎和胆囊癌[J].中国医学影像技术,2011,27(2):333-336.
[5] 周粼,宛宝生,唐浩然,等.从胆囊结石患者患胆囊癌的风险看胆囊结石的治疗[J].云南医药,2011,32(2):162-164.
[6] 张宪祥,张炳远,卢云,等.胆囊癌并出血伴血凝块致梗阻性黄疸(附1例报告)[J].青岛大学医学院学报,2010,46(3):269.
[7] 余红胜,沈又利,吉六舟,等.慢性胆囊炎与壁厚型胆囊癌的CT鉴别诊断[J].中国医学计算机成像杂志,2012,18(4):322-325.
[8] 周建海,丁峰,谢绍辉.CT和超声鉴别诊断胆囊癌与慢性胆囊炎的意义[J].实用心脑肺血管病杂志,2012,20(8):1371-1372.