The imaging features and value of multi-slice spiral CT in the diagnosis of internal biliary fistulas

Abstract

Objective To analyze the typical imaging features of various internal biliary fistulas by multislice spiral CT (MSCT), and the diagnostic value. Methods the data of 56 cases of internal biliary fistula in Wuxi No. 2 Affiliated Hospital of Nanjing Medical University from January 2011 to March 2018 were analyzed retrospectively. All cases were examined by MSCT plain scan and enhanced examination. The imaging features of various biliary fistula were analyzed and studied. Results Among 56 cases of biliary fistula, 39 cases were gallbladder duodenum fistula, and the diagnostic sensitivity was 87.2% (34/39). The total coincidence rate was 85.7% (48/56). 21 cases were fistula formation, and 11 cases of narrow neck syndrome. Gallbladder bile duct fistula, liver-gallbladder fistula, bile duct and duodenal fistula of 6 cases were showed. In 4 cases of complex gallbladder fistulas, 3 cases showed fistula clearly including 2 cases of fistula and a clover sign. In the indirect CT signs of 56 cases of internal biliary fistula, the common imaging features: atrophy of gallbladder or incarceration, stone incarceration of biliary tract, gallbladder or choledochal duct and cavity viscera. Conclusion MSCT scan can not only distinguish the type of biliary fistula and the structure of fistula, but also display the fistula, shape, atrophy of gallbladder, gallbladder and bile duct gas, stone and surrounding conditions, which have important guiding significance for the formulation of the operation scheme. Key words: Internal biliary fistula; Gallstone ileus; Multi-slice spiral CT(MSCT); Diagnosis