| ObjectiveTo investigate the display conditions of cystic artery and cystic duct withcholecystolithiasis and cholecystolithiasis with cholecystitis, assessing cystic arteryand cystic duct with256-detector row ct before laparoscopic cholecystectomy.MethodsChoose the cases of cholecystolithiasis which CT non-contrast enhanced scan orultrasonography showed as the experimental group（cholecystolithiasis group）in theZhongshan City People’s Hospital from August2012to March2014, using thevascular contrast agent iopamidol（370mgI/ml） or iohexo（350mgI/ml）to undergothe epigastric enhancement scan and the displaying of cystic artery and cystic duct；Choose the cases of non-gallbladder disease as the control group（non-gallbladderdisease group） at the same time, using the vascular contrast agent Iopamidol（370mgI/ml） or iohexo（350mgI/ml）to undergo the epigastric enhancement scanand the displaying of cystic artery and cystic duct as well. The data of cystic arteryand cystic duct which included the rate of display, the scores of display, natomicalstructure and variation in the two groups were observed and recorded.According to the clinical symptoms, signs and gallbladder CT display, thecholecystolithiasis group was further divided into the simple cholecystolithiasis group,the cholecystolithiasis with acute cholecystitis group and the holecystolithiasis withchronic cholecystitis group. Statistical method：1.The rate of display of cystic artery and cystic duct in the cholecystolithiasis groupand the control group were compared via Chi square test.2.The scores of display of cystic artery and cystic duct in the cholecystolithiasis groupand the control group were compared via t test, then the scores of display of cysticartery and cystic duct in the simple cholecystolithiasis group, the cholecystolithiasiswith acute cholecystitis group, the cholecystolithiasis with chronic cholecystitis groupand the control group were multiple compared via t test.3.The course variation of cystic artery and cystic duct in the cholecystolithiasis groupand the control group were compared via Chi square test.Results1. The rate of display and the scores of display of cystic duct:(1)The display rate of cystic duct：the cholecystolithiasis group was93.2%(96/103)and the control group was100%(71/71).The chi square test showed that the twogroups had statistical significance (P<0.05), suggesting that the rate of display ofcystic duct of the cholecystolithiasis group was lower than the control group’s. The7cases of the cholecystolithiasis group which can not be displayed were all come fromthe cholecystolithiasis with acute cholecystitis group.The rate of display of cystic ductof the cholecystolithiasis with acute cholecystitis group was77.4%(24/31),suggesting that cholecystolithiasis with acute cholecystitis group was the reason thatthe rate of display of the cholecystolithiasis group was lower than the control group’s.(2)The scores of display of cystic duct：the mean±standard deviation of thecholecystolithiasis group was1.54±0.62and the mean±standard deviation of thecontrol group was1.65±0.48.The t test showed that the two groups had no statisticalsignificance(P>0.05), suggesting that there was no significant difference of the scoresof display of cystic duct between the cholecystolithiasis group and the control group.Multiple comparisons between each group showed that the mean±standard deviationof the cholecystolithiasis with acute cholecystitis group was lower than any othergroup（the simple cholecystolithiasis group, the cholecystolithiasis with chroniccholecystitis group and the control group）（P>0.05）, suggesting that the scores ofdisplay of cystic duct of the cholecystolithiasis with acute cholecystitis group waslower than any other group.The display of cystic duct in the cholecystolithiasis withacute cholecystitis group was relatively poor. 2. The rate of display and the scores of display of cystic artery:(1)The rate of display of cystic artery：the cholecystolithiasis group and the controlgroup were100%, suggesting that cholecystolithiasis and cholecystolithiasis withcholecystitis were not influence the rate of display of cystic artery.(2)The scores of display of cystic artery：the mean±standard deviation of thecholecystolithiasis group was1.67±0.72and the mean±standard deviation of thecontrol group was was1.52±0.50.The t test showed that the two groups hadstatistical significance(P 〈0.05), suggesting that cholecystolithiasis andcholecystolithiasis with cholecystitis were not influence the scores of display of cysticartery. Multiple comparisons betweent each group showed that the mean±standarddeviation of the cholecystolithiasis with chronic cholecystitis group was higher thanthe control group（P<0.05）while the other groups were compared with each otherwithout statistical significance, and it was probably due to long-term chronicinflammation leads to the diameters of the cystic artery enlarger, so the CT imaging ofthe cystic artery was better.3. The course variation of cystic duct and cystic artery:There were10cases of course variation of cystic duct in the cholecystolithiasis groupand the rate of course variation was10.4%(10/96). There were13cases of coursevariation of cystic duct in the control group and the rate of course variation was18.3%(13/71).The chi square test showed that two groups had no statisticalsignificance (P>0.05).There were13cases of course variation of cystic artery in thecholecystolithiasis group and the rate of course variation was13.5%(13/96). Therewere11cases of course variation of cystic duct in the control group and the rate ofcourse variation was15.5%(11/71).The chi square test showed that two groups hadno statistical significance (P>0.05).The result suggesting that cholecystolithiasis andcholecystolithiasis with cholecystitis would not influence the course of cystic duct andcystic artery, the course variation of cystic duct and cystic artery in two groups werecaused by congenital variation.Conclusion1. CT can better display the cystic duct (the rate of display was93.2%, the score ofdisplay was1.54±0.62) and cystic artery(the rate of display was100%, the score ofdisplay was1.67±0.72) at the time of the cholecystolithiasis and cholecystolithiasis with cholecystitis.2. cystic duct displayed relatively poor (the rate of display was77.4%, the score ofdisplay was1.06±0.73) at the time of the cholecystolithiasis with acute cholecystitis,so the imaging of cystic duct should avoid that time as far as possible.3. cholecystolithiasis and cholecystolithiasis with cholecystitis would not influencethe course of cystic duct and cystic artery and the course variation of cystic artery andcystic duct in two groups were all caused by congenital variation. |
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