[1]孟晓春,朱康顺,徐川,等.肝移植术后不同类型胆道狭窄的多层CT诊断价值[J].介入放射学杂志,2009,(03):200.
　MENG Xiaochun,ZHU Kangshun,XU Chuan,et al.The role of multislice spiral CT in diagnosing different biliary strictures after liver transplantation[J].journal interventional radiology,2009,(03):200.
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肝移植术后不同类型胆道狭窄的多层CT诊断价值()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2009年03期
页码:
200
栏目:
非血管介入
出版日期:
2009-03-15

文章信息/Info

Title:
The role of multislice spiral CT in diagnosing different biliary strictures after liver transplantation
作者:
孟晓春; 朱康顺; 徐川; 等
５１０６３０广州，中山大学附属第三医院放射科
Author(s):
MENG Xiao－chun; ZHU Kang－shun; XU Chuan; PENG Ling－rong; JIANG Tin; LIU Lin－yun; SHAN Hong．
Department of Radiology，the Third Affiliated Hospital，Sun Yat－sen University，Guangzhou５１０６３０，China
关键词:
肝移植; 胆道并发症; 体层摄影术; X线计算机; 胆道造影术
分类号:
R５７５.７
文献标志码:
A
摘要:
目的探讨肝移植术后不同类型胆道狭窄的多层CT表现及诊断价值。方法以５５例经皮胆道造影（PTC）或内镜逆行胆道造影（ERC）证实的移植术后胆道狭窄患者为对象，分析缺血型胆道狭窄（IBS）２３例及非缺血型胆道狭窄（NIBS）３２例患者的肝内、外胆道及肝动脉病变情况，根据二项分布样本总体概率的Z检验比较两组多层CT表现差异。结果多层CT检查中，５４／５５例（９８．２％）胆道狭窄患者发现不同程度胆管扩张，１例弥漫性肝内胆管狭窄、无肝内外胆管扩张的IBS患者漏诊。IBS患者肝门区胆管狭窄（２１例，９１．３％）、肝内胆管不均匀扩张（１６例，６９．６％）发生率显著高于NIBS患者（分别为４例，１２．５％和１２例，３７．５％）（单侧P值＜０．０１）；胆总管吻合口狭窄（８例，３４．８％）、肝外胆管扩张（８例，３４．８％）、肝内胆管均匀扩张（６例，２６．１％）发生率显著低于NIBS患者（分别为２７例，８４．４％、２９例，９０．６％和２０例，６２．５％）（单侧P值＜０．０１）。CTA发现１６／２３例IBS及５／３２例NIBS患者肝动脉狭窄，IBS患者肝动脉狭窄发生率高（单侧P＜０．０１）。IBS组５例合并肝内胆汁瘤及２例合并胆源性肝脓肿患者全部出现重度以上肝动脉狭窄。２／３例胆漏患者合并IBS，CTA发现１例肝动脉血栓、１例极重度肝动脉狭窄。结论IBS、NIBS在胆道狭窄部位、继发性胆管扩张部位和肝内胆管扩张多层CT上有不同的表现特征，肝门区胆管狭窄及肝内胆管不均匀扩张为IBS主要表现；CTA还能发现相关血管病变，为临床治疗提供参考。

参考文献/References:

［１］Moser MA，Wall WJ．Management of biliary problems after liver transplantation［J］．Liver Transpl ，２００１，７：S４６－S５２．
［２］Moench C，Uhrig A，Lohse AW，et a１．CC chemokine receptor５delta３２polymorphism－a risk factor for ischemic－type biliary lesions following o

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备注/Memo

备注/Memo:
收稿日期：２００８－１１－０３
基金项目：广东省自然科学基金团队研究资助项目（０５２００１７７）
更新日期/Last Update: 2009-03-15