十二指肠乳头旁憩室致梗阻性黄疸的影像学诊断价值

摘要

Objective: To investigate the value of C T and MRI in diagnosis of periam pullay duodenal diverticulum com plicated with obstructive juindice. Meihods: C T or MRIm anifestation of 18 patients with periam pullay duodenal diverticula com plicated w ith obstructive jmndice w ere retrospectively analyzed, all cases w ere confirm ed by surgery, upper gastrointestinal barium meal exam ination or gastroscopy. Results: In 18 cases, the aged ranged from 62 to 93 years(m ean 74 years) . 11 cases w ere less than 2 cm in periam pullay diverticulum diam eter,7 cases w ere m ore than 2 cm . C T and MRI appeared be1w een pancreatic head and duodenum as circular or sem icircukr in shape w ith gaseous density, w hich had a air-fhud level. 18 cases of periam pullay duodenal diverticula w ere associated w ith different degrees of obstruction of biliary system expansion. Enhanced scan periam -pullay duodenal diverticulum and adjicent local intestinal w all w as strengthened . C onclusion: C T and MRI should be beneficial to the diagnosis of periam pullay duodenal diverticulum com plicated w ith obstructive jumdice.%目的:探讨十二指肠乳头旁憩室(PAD)致梗阻性黄疸的CT或MRI表现.方法:分析18例PAD伴梗阻性黄疸的CT或MRI表现,所有病例均经手术、上消化道钡餐检查或胃镜检查确诊.结果:本组18例中,憩室直径小于2 cm的11例,大于2 cm的7例.PAD的CT和MRI表现为胰头右后方与十二指肠之间圆形或半圆形含气囊袋影,可见液气平面,部分憩室内可见食物残渣影.18例PAD均伴有胆道系统不同程度的梗阻扩张.增强扫描憩室壁及相邻十二指肠局部肠壁明显强化.结论:CT和MRI对PAD致梗阻性黄疸有十分重要的诊断价值.