The Diagnosis Value Of128-Slice Spiral CT In Obstructive Jaundice Diseases In Lower Segment Of Bile Duct

ObjectiveExplore the diagnosis, value of identifying diagnosis with128-slice spiralCT of obstructive jaundice diseases in lower segment of bile duct, providingmore useful help for clinical early diagnosis and treatment plan. Evaluation thespecificity, sensitivity and accuracy of128-slice spiral CT in diagnosis ofobstructive jaundice diseases in lower segment of bile duct.MethodsCollect clinical data and imaging information of77patient cases ofobstructive disease in lower segment of bile duct, divided into2groups, in which41cases are benign and36cases are malignant. All patients were underwent a128-slice spiral CT scan, arterial and venous phase enhanced scan, withobtained the original data delivering to the Siemens workstation for imagereconstruction. Among them, patients with suspected malignant obstructivejaundice need to do PTC examination. All patients had pathological findings.Two imaging experts analyzed the above two groups of data in case ofcontroversial diagnosis occurred; the third physician would be needed toparticipate joint discussion to determine the final result. SPSS16.0was used toinput all clinical and radiographic parameters into computer in order for thestatistical analysis by statistical software.ResultsAll cases have a clear image display.1. In diagnosis of128-slice spiral CT against degree of bile duct obstructionrate of accuracy, sensitivity and specificity are96.10%，95.12%，97.22% respectively.2. There is statistical meaning in the bile duct dilation degree andobstruction end difference between benign obstruction and malignantobstruction (P<0.05). There is also consistent analysis in bile duct dilationdegree of malignant obstruction in lower segment of bile duct, Kappa=0.89.3. There is significant meaning for128-slice spiral CT in diagnosis ofdistance between obstruction end and portahepatis among benign obstructionand malignant obstruction (P<0.01); there is also statistical meaning in thedifference between bile duct cancer and pancreatic cancer among malignantobstruction group(P<0.05); there is no statistical meaning in distance ofobstruction position and portahepatis between PTC and128-slice spiral CT(P>0.05).ConclusionsAs a kind of non-invasive treatment,128-slice spiral CT should become oneof routine examinations in diagnosis of suspected obstructive jaundice diseases;with features of high accuracy, sensitivity and specificity,128-slice spiral CTscan would contribute to the diagnosis and identifying diagnosis. There arehighly consistent results in comparing128-slice spiral CT scan and PTC indetection bile duct dilation of malignant obstructive jaundice diseases as well asthe diagnosis of distance between malignant obstruction and portahepatis.Tosum up,128-slice spiral CT scan is a very effective method to the obstructivejaundice diseases in lower segment of bile duct.