目的　探讨多排螺旋CT三维成像技术对胆系疾病的诊断价值。方法　 146例胆系疾病患者 ,其中胆系肿瘤 73例 ,胆系阴性结石 87例 ,胆肠吻合术后 12例 ,先天性胆总管囊肿 1例。CT容积扫描所获图像数据送工作站处理 ,选择合理的成像方法 ,胆系成像方法包括最大密度投影法(MIP)、最小密度投影法 (MinP)、仿真内窥镜 (CTVE)、表面遮盖法 (SSD)和Raysum。对比分析胆系成像、常规CT、US及ERCP对各疾病的诊断准确率。结果　各疾病在胆系成像上均有较特征性的表现 ;胆系成像是一种评价胆肠吻合术的新手段 ;对胆系结石、胆总管癌、胆管癌栓、胰头癌、壶腹周围癌的诊断 ,胆系成像优于常规CT、US、ERCP ;对于肝门部胆管癌的诊断 ,胆系成像优于常规CT、US ,与ERCP相当 ;对胆囊癌的诊断 ,不如常规CT、US。结论　胆系成像是一种诊断胆系疾病的无创、敏感的新方法 ,确诊率高 ,将极大地提高胆系疾病的术前诊断水平。 Objective To investigate the diagnostic value of multi-slice spiral CT in the diagnosis of biliary diseases. Methods A total of 146 patients with biliary diseases were included, including 73 cases of biliary tumors, 87 cases of biliary negative stones, 12 cases of choledochojejunostomy and 1 case of congenital choledochal cyst. CT volume scan image data sent to the workstation to process, select a reasonable imaging method, gallbladder imaging methods including maximum density projection (MIP), minimum density projection (MinP), simulation endoscopy (CTVE) SSD) and Raysum. Comparing the diagnostic accuracy of gallbladder imaging, conventional CT, US and ERCP for various diseases. Results The results showed that all the diseases had characteristic manifestations in gallbladder imaging. Gallbladder imaging was a new method to evaluate choledochojejunostomy. The gallstone, cholangiocarcinoma, cholangiocarcinoma suppository, pancreatic head cancer, ampulla The diagnosis of peripheral cancer, gallbladder imaging superior to conventional CT, US, ERCP; for the diagnosis of hilar cholangiocarcinoma, gallbladder imaging superior to conventional CT, US, and ERCP; diagnosis of gallbladder cancer, not as good as conventional CT, US. Conclusion Gallbladder imaging is a new noninvasive and sensitive method for the diagnosis of biliary diseases. The high diagnosis rate will greatly improve the preoperative diagnosis of biliary diseases.