Study Of The Spiral CT Value In Diagnosis Of Diseases At The Junction Area Of Choledochopancreatic Duct And Duodenum

Objective To investigate-the spiral CT findings of diseases at the Junction Area of Choledochopancreatic Duct and Duodenum(DJACDD) which caused obstruction of biliary duct so as to improve diagnosis and differential diagnosis rate.Materials and Methods The spiral CT findings of 84 cases of DJACDD which caused obstruction of biliary duct were retrospectively analyzed. All the cases were confirmed by operation and pathology or clinical integrated diagnosis, and were divided into benign obstruction group (BOG) and malignant obstruction group(MOG).Observation was focused on the form of obstruction of biliary duct,the maximum diameter of the dilated common bile duct (CBD), the double duct sign; the display rate of tumor,the maximum diameter of tumor, the enhancement characteristic and the circumference invasion in MOG, et al. The comparison analysis was made between BOG and MOG, and also between carcinoma of ampulla of Vater (CAV) and carcinoma of head of pancreas(CHP) combined with the clinical resectable rate of the two groups.Results In the MOG, the rate of abrupt obstruction of the dilated CBD was 91.2%(52/57), compared with 25.9%(7/27) in the BOG; The appearance rate of the double duct sign in BOG was only 22.2%(6/27), compared with 75.4%(43/57) in MOG; The average of the maximum diameter of the dilated CBD in BOG and MOG was 1.4148和0.4285和2.1807±0.5802 respectively; The differences of all these data in the two groups were very remarkable (P<0.01). For the MOG, the display rate of tumor in CAV was 72.7%(24/33), compared with 100%(21/21) in CHP; Analyzing enhancement characteristics for the tumors displayed by spiral CT, it was founded that the rates of not obviously enhanced cases were 37.5%(9/24) and 100%(21/21) in CAV and CHP respectively; The circumference invasion rates were 24.2%(8/33) and 76.2%(16/21) in CAV and CHP respectively; And the clinical resectable rate of the two groups was 78.8%(26/33) and 23.8%(5/21) respectively; The differences of all these data in the two groups were remarkable too (P<0.05).Conclusion Characteristic spiral CT findings can be helpful for the diagnosis and differential diagnosis of DJACDD, and be of important significance in putting forward the therapeutic programme and estimating the prognoses.