肝外胆管梗阻病变MSCT曲面重建胆管成像与MRCP的比较研究

目的比较多层螺旋CT（MSCT）曲面重建（CPR）胆管成像与磁共振胰胆管成像（MRCP）对肝外胆管梗阻病变的诊断价值。方法66例经B超检查提示有肝外胆管梗阻病变的患者，采用单次激发快速自旋回波（SSFSE）序列，行MRCP检查，同期采用10mm层厚层距，使用血管对比剂，行MSCT增强扫描，将门静脉期图像采用2．5mm层厚、1．25mm层距重建，获得轴面源像（ASI），数据传输至图像工作站，作CPR胆管成像。比较CPR胆管成像、MRCP对肝外胆管梗阻病变的定位、定性诊断价值。结果CPR胆管成像、MRCP成功率为100％；CPR胆管成像、MRCP均对肝外胆管梗阻部位做出明确诊断，定位诊断率为100％；CPR胆管成像、MRCP定性诊断率分别为95．5％和80．9％。结论CPR胆管成像、MRCP对肝外胆管梗阻病变均能明确定位，CPR胆管成像定性诊断率明显高于MRCP，CPR胆管成像显示胆管及其周围病变与扩张胆管的关系更直观。

The comparative study of curved planar reconstruction with MSCT and MRCP in diagnosis of extrahepative biliary obstructic disease

Objective To compare the diagnostic value of curved planar reconstruction(CPR) with multi-slice spiral CT(MSCT) and magnetic resonance cholangiopancreatography(MRCP) for extrahepative biliary obstructic diseases.Methods MRCP using single-shot fast spin echo(SSFSE) sequences was performed in 66 cases with extrahepative biliary obstructic diseases in whom previously had received B-mode ultrasound.After MRCP examinations,MSCT enhancing scanning using vascular constrast was performed with a 10 mm collimation thickness and interval.The row data of portal venous phase was first reformated to bring out axial source images(ASI) with a 2.5 mm collimation thickness and 1.25 mm reconstruction interval.The ASI image data was conveyed to workstation and dealt with CPR.The CPR and MRCP were compared in the value of location and quality of extrahepative biliary obstructic diseases.Results The successful rate of CPR and MRCP was 100 %.The CPR and MRCP diagnosed the location of extrahepative biliary obstruction accurately.The locating accuracy for CPR and MRCP was 100 %.The qualitative accuracy for CPR and MRCP was 95.5 % and 80.9 % respectively.Conclusion The CPR and MRCP can accurately define the obstructive site in extrahepative biliary obstructic diseases.The CPR is more accurate in identifying the quality of obstruction than MRCP.The CPR is more unambiguous on showing the relation between biliary diseases and dilated bile ducts.