磁共振胰胆管造影诊断胆管系统结石

目的：评价磁共振胰胆管造影在胆管系统结石中的诊断价值。材料和方法：对１００例胆管系统结石的患者进行了ＭＲＣＰ检查，采用不屏气快速自旋回波（ＦＳＥ）序列重Ｔ２加权成像，并用呼吸触发、脂肪抑制和最大信号强度投影（ＭＩＰ）的三维重建方法。对ＭＲＣＰ的诊断结果与手术或临床作了对照分析。结果：本组病例均获得了诊断质量的ＭＲＣＰ图像；１００例胆道结石的患者共有１５８处结石：肝内胆管结石２６例次，胆囊结石５６例次，总胆管结石７３例次和总肝管结石３例次。胆管系统结石的主要ＭＲＣＰ表现为：圆形或卵圆形信号缺失（充盈缺损）；倒杯口征；靶征；铸型样结石。ＭＲＣＰ结合原始图像对胆管系统结石诊断总检出率为９０％，而ＭＲＣＰ对胆管系统结石诊断部检出率为８２％两者比较（Ｐ〈０．０５）。结论：ＭＲＣＰ结合原始图像对胆管系统结石的诊断有较高的准

MR Cholangiopancreatography in Diagnosis of Bile Stones

Purpose: To evaluate the significance of MR cholangiopanc reatography(MRCP) in the diagnosis of bile stones.Materials and Methods: MRCP were performed in 100patients with bile stones, and non - breath - hold heavy T2WI TSE sequence with respiratory triggering, fat surppression technique and maximum intensity projection (3D)reconstruction was used. The findings of MRCP compared with surgical findings or clinical diagnosis. Results: MRCP images of diagnostic quality were obtained in all cases. Of 100 cases with. bile stone , 158 sites with stones were found, including intrahepatic bile duct stone 26, gallbladder stone 56, common bile duct stone 73 , and common hepatic duct stone 3. Four types of MRCP manifestations were presented: round or ovoid signal void sign(filling defect sign); reverse curpping sign; target sign and cast sign. The diagnostic accuracy for MRCP combined with MRCP source images was significantly better than which for MRCP only(90%: 82% , P < 0. 05). Conclusion: MRCP combined with MRCP source images has a high diagnostic accuracy in the diagnosis of bile stones, and it may be the first choice of non - invasive diagnostic modality and will partly replace some invasive techniques, such as ERCP, PTC.