目的探讨256层螺旋CT动态容积扫描对肝门部胆管癌的诊断价值。方法对胆管癌病患30例采用256层螺旋CT技术,分析病患的肿块程度、密度及临床手术可行性。结果由F值检验可知,不同时期病灶检出情况有显著差异,其中平扫检出的肿块量最低。差异均有统计学意义(均P<0.05)。动脉期的肿瘤-肝CT值差为(26±9)HU均明显高于平扫期、门脉期。差异均有统计学意义(均P<0.05)。CT类型与手术类型大体一致,准确度为73.3%(22/30)。(根据Kappa检验,发现Kappa值>0.4。)CT评估与术中评估大体一致,准确度为73.3%(22/30)。(根据Kappa检验,发现Kappa值>0.4)。结论 256层螺旋CT动态容积扫描可清晰扫描出病患的肿块范围及密度,对手术分型及肿瘤的切除性评估也较为精确。意义远大,值得推荐。 Objective To investigate the diagnostic value of dynamic 256-slice CT in the diagnosis of hilar cholangiocarcinoma. Methods Thirty patients with cholangiocarcinoma were examined by 256-slice spiral CT. The degree of tumor, density and clinical feasibility were analyzed. Results F-value test shows that there are significant differences in the detection of lesions at different stages, of which the amount of mass detected by plain scan is the lowest. The differences were statistically significant (all P <0.05). The difference of tumor-liver CT value at arterial phase was (26 ± 9) HU, which was significantly higher than that at the scan and portal phase. The differences were statistically significant (all P <0.05). The type of CT was roughly the same as the type of surgery with an accuracy of 73.3% (22/30). (According to the Kappa test, a Kappa value of> 0.4 was found.) CT assessment was generally consistent with intraoperative assessment, with an accuracy of 73.3% (22/30). (Kappa value> 0.4 according to Kappa test). Conclusion 256-slice spiral CT dynamic volume scan can clearly scan the patient’s tumor size and density, and the surgical classification and tumor resection assessment is also more accurate. Meaningful, it is recommended.