肝外胆管梗阻的磁共振胆胰管造影诊断

目的 评价磁共振胆胰管造影（ＭＲＣＰ）对肝外胆管梗阻性疾病的临床诊断价值。方法 对５４例肝外胆管梗阻性疾病（肝外胆管结石３０例，恶性胆管梗阻２４例）进行ＭＲＣＰ检查，并与临床诊断或手术和病理结果对照分析。ＭＲＣＰ采用不屏气快速自旋回波（ＴＳＥ）序列重工Ｔ２ＷＩ扫描，结合呼吸触发及脂护抑制技术，原始图像以最大信号强度投影（ＭＩＰ）法进行三维重建。结果 全部５４例ＭＲＣＰ检查均一次成功，５２例胆胰管显

MR cholangiopancreatography in diagnosis of extrahepatic bile duct obstruction

Objective To evaluate the clinical value of MR cholangiopancreatography (MRCP) in diagnosis of extrahepatic biliary obstructive disease Methods MRCP was performed in 54 patients, including 30 cases of extrahepatic bile duct stone and 24 cases of malignant biliary obstruction The results of MRCP were compared with clinical diagnosis or surgical findings and pathology Non breath hold heavy T 2 weighted TSE sequence with respiratory triggering and fat suppression techniques was used The source images were reconstructed by using three dimensional (3D) maximum intensity projection (MIP) algorithm Results MRCP examination succeeded in all 54 patients and the pancreaticobiliary duct was shown satisfactorily in 52 cases The accuracy of MRCP in the detection of the degree and level of extrahepatic bile duct obstruction was 100% and the accuracy for evaluating the causes of obstruction was 88 9% In diagnosis of extrahepatic bile duct stone and malignant biliary obstruction, the diagnostic rate of MRCP was 96 7% and 79 2%, respectively Conclusions MRCP examination has a high successful rate and can accurately define the level of extrahepatic bile duct obstruction Combining with the source images and routine MRI scanning for analysis, the specificity for the diagnosis of extrahepatic bile duct stone and malignant biliary obstruction is also high MRCP may substitute for diagnostic direct cholangiopancreatography and provide an optimal alternative, especially when diagnostic ERCP and PTC are unsuccessful or inadequate