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目的探讨VCT三维重建联合ERCP后仿真内窥镜在肝门胆管癌诊断中的价值。方法对30例肝门胆管癌三期增强扫描及ERCP术后VCT扫描图像进行分析,利用工作站对原始图像进行后处理(包括MPR、VR、CTVE等技术),判断肿瘤的部位和侵及范围,肝动脉和门静脉受侵情况,是否有局属淋巴结及脏器转移;将Bismuth-Corlette分型及术前评估结果与手术结果进行对照分析。结果 30例患者均行VCT三期增强扫描后行图像三维重建及ERCP后仿真内窥镜重建,本组对于肝门胆管癌定性诊断准确率为100%(30/30),定位分型准确率为80%(24/30)。结论应用VCT三维重建联合ERCP后仿真内窥镜技术可作为肝门胆管癌诊断的首选有效方法 。
Objective To investigate the value of virtual endoscopy in diagnosis of hilar cholangiocarcinoma after three-dimensional reconstruction combined with ERCP. Methods Thirty patients with hilar cholangiocarcinoma underwent phase III enhanced scan and VCT scan after ERCP were analyzed. The original images were post-processed by workstation (including MPR, VR, CTVE and other techniques) to determine the location and extent of tumor invasion. Hepatic artery and portal vein invasion, whether there is lymph node and organ metastasis; the Bismuth-Corlette classification and preoperative evaluation results and surgical results were analyzed. Results Thirty patients underwent three-dimensional reconstruction with VCT three-phase enhanced CT scan and endoscopic reconstruction after ERCP. The accuracy rate of qualitative diagnosis of hilar cholangiocarcinoma in this group was 100% (30/30) 80% (24/30). Conclusion The application of VCT 3D reconstruction and ERCP simulation endoscopy can be the first choice of effective method for the diagnosis of hilar cholangiocarcinoma.