The Diagnostic Study Of Extrahepatic Cholangiocarcinoma Based On 64-detector Spiral CT

The main symptoms disease of obstructive jaundice is relatively common in clinical. Extrahepatic cholangiocarcinoma (CC) is a malignant bile duct disease. Because of its incidence and imaging diagnosis rates have increased, more and more doctors pay attention to it.The purpose of this paper include:1. the preparing method of CT scanning of the stomach and duodenum; 2. the image quality comparison between 16-detector spiral CT (Philips Brilliance 16-detector spiral CT) and 64-detector spiral CT (GE VCT Light Speed 64-detector spiral CT machine); 3. the diagnosis value of 64-detector spiral CT in extrahepatic cholangiocarcinoma and the CT signs of extrahepatic cholangiocarcinoma.This study included 78 cases of extrahepatic CC, out of which 52 cases underwent 64-detector spiral CT scans while 28 patients had done a CT scan on a 16-detector spiral CT. All the patients were asked to fast for 6-8 hours before the CT scan of the abdomen. Twenty minutes before the scan, all patients were divided into two groups. One group was asked to drink around 800-1000 ml of lukewarm water while the other group was injected 2ml of 654-2 intramuscularly to reduce the intestinal motility and then asked to drink water. After the CT scan, the data were transmitted to ADW4.3 workstation, where we carried out think layer reconstruction and also got the ASI image and post-processing images such as volume rendering (VR), mulitplanar reconstructions (MPR), curved planar reconstructions (CPR), and minimum intensity projection (MinIP). We compared their utilization respectively with emphasis on the ASI, CPR, and MPR evaluation. We graded the imaging quality and evaluated whether there were statistically significant difference between the two groups. Evaluation of this study included:1. The tumor size, shape and location; 2. Invasion and metastases around the tumor 3. Comprehensive evaluation of the tumor. A p-value=0.05 was considered to be statistically significant. Final diagnosis of extrahepatic CC was confirmed by surgery, Biopsy done through ERCP/PTC and pathology reports.The results show that there was statistically significant difference between guide drinking water group and low-tension+guide drinking water group (χ2=5.759, P<0.05).64-detector spiral CT image quality was better than 16-detector spiral CT image quality and the difference was statistically significant (Z=-3.216, P=0.001< 0.05)In the 52 routine 64-slice spiral CT scans, ASI, MPR and CPR applications are most wide among the patient's various reconstruction image. In the field of oneself characteristic demonstrating a tumour, CPR is superior to MPR and the difference was statistically significant (χ2=4.981, P=0.026<0.05). In the field of the sign demonstrating tumour adjoint, MPR is superior to CPR and the difference was statistically significant (χ2=8.508, P=0.004<0.05). Comprehensive evaluation of disease should be combined ASI+CPR+MPR, and the diagnosis rate is higher than ASI group, although no significant difference between the two methods (χ2=2.748, P=0.097>0.05)①low-tension+guide drinking water law is the best method of abdominal examination.②The 64-detector spiral CT should be widely used, because the image quality of 64-detector spiral CT is better than 16-slice spiral CT.③In the field of oneself characteristic demonstrating a tumour, CPR is superior to MPR. In the field of the sign demonstrating tumour adjoint, MPR is superior to CPR.④Comprehensive evaluation of disease should be combined ASI+CPR+MPR.⑤The master enhanced manner of cholangiocarcinoma (mass) is delayed enhancement.⑥ Hilar cholangiocarcinoma is often accompanied by reduced gallbladder.