目的 探讨64排螺旋CT诊断肝外 胆管癌的临床价值。方法 选择经手术病 理或活检证实为肝外胆管癌的44例患者， 回顾性分析其CT影像学资料，总结肝外胆 管癌CT表现特征及64排螺旋CT诊断价值。 结果 肝外胆管癌以肿块型多见，其次为 管壁浸润型，腔内乳头状少见。肝门胆管 癌以肿块型居多，CT密度不均，边界模 糊，管壁浸润者管壁不规则增厚，部分伴 管腔狭窄。腔内乳头型CT可见不规则结节 状影，突向管腔。中下段胆管癌腔内乳头 状病变多见，管壁浸润型次之，影像学表 现与肝门区胆管癌类似。结论 64排螺旋 CT配合重建技术是肝外胆管癌诊断的理想 影像学手段。

Objective To investigate the clinical value of 64 slice spiral CT in the diagnosis of extrahepatic bile duct carcinoma. Methods 44 cases of patients with extrahepatic bile duct carcinoma confirmed by surgery and pathology or biopsy were included in the study. The CT imaging data were retrospectively analyzed. The CT findings of extrahepatic bile duct carcinoma and the diagnostic value of 64 slice spiral CT were summarized. Results Most of extrahepatic bile duct carcinomas were mass type, followed by tube wall infiltration type and intracavity papillary ones were rare. Most hilar cholangiocarcinomas were mass type and the CT density was inhomogeneous, with fuzzy boundaries. Those with tube wall infiltration were with irregular wall thickening and some were with luminal stenosis. CT of intracavity papillary type showed irregular nodular shadow, protruding into the lumen. In terms of middle and distal bile duct carcinoma, intracavity papillary lesions were the most, followed by wall infiltration type and the imaging findings were similar to those of anal bile duct carcinoma. Conclusion 64 slice spiral CT with reconstruction technique is a ideal imaging means of diagnosing extrahepatic bile duct carcinoma.