胆系结石的磁共振胆胰管成像的临床评价

目的评价磁共振胆胰管成像(MRCP)对胆系结石的临床诊断价值。方法对20例胆系结石(胆囊结石6例,肝内胆管结石2例,肝外胆管结石11例)进行MRCP检查,并经手术病理和(或)其他影像学和临床资料证实。MRCP采用不屏气快速自旋回波(TSE)序列重度T2WI扫描,结合呼吸触发及脂肪抑制技术,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20例MRCP检查均一次成功,19例胆胰管显示满意。MRCP对胆系结石梗阻定位诊断准确率为100%,定性诊断准确率为95%,其中MRCP诊断肝外胆管结石准确率为100%。结论MRCP检查成功率高,结合原始图像和常规MRI扫描,MRCP对胆系结石特别是胆囊及肝外胆管结石诊断准确率较高。

Magnetic resonance cholangiopancreatography in diagnosis of biliary system calculus

Objective To evaluate the clinical value of magnetic resonance cholangiopancreatography （MRCP） in diagnosis of hiliary system calculus. Methods MRCP was performed in 20 patients, including 6 cases of cholecystolithiasis, 2 cases of intrahepatic bile ducts stone and 11 cases of extrahepatic bile ducts stone. The results of MRCP were compared with surgical findings and pathology or clinical diagnosis. Non-breath-hold heavy T2 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 20 patients and the pancreaticobiliary duct was shown satisfactorily in 19 cases. The accuracy of MRCP in the detection of the degree and level of biliary system calculus was 100% and the accuracy for evaluating the causes of obstruction was 95%. In diagnosis of extrahepatic bile duct stone, the diagnostic rate of MRCP wasl00%. Conclusion MRCP examination has a high successful rate. Combining with the source images and routine MRI scanning for analysis, the specificity for the diagnosis of extrahepatic bile duct stone and cholecystolithiasis is also high.