磁共振胰胆管造影在肝外胆道梗阻性疾病中的应用价值分析

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 2 9例肝外胆管梗阻性疾病 (肝外胆管结石 9例 ,恶性胆管梗阻 18例 ,胆囊周围淋巴结反应性增生 1例 ,胆囊结石 1例 )进行MRCP检查 ,并与术后病理结果或临床综合诊断对照分析。MRCP采用屏气单次激发半数傅立叶变换的TSE序列 (HASTE) ,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 2 9例MRCP检查均一次成功 ,2 7例胆胰管显示满意。MRCP对肝外胆管梗阻性疾病的定位诊断率为 10 0 % ,定性诊断率为 79.3 %。结论　MRCP检查成功率高 ,对肝外胆管梗阻的定位诊断准确 ,结合原始图像和常规MRI扫描 ,对肝外胆管结石和恶性胆管梗阻的定性诊断也有较高的准确性

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 29 patients, including 9 cases of extrahepatic bile duct stone,18cases of malignant biliary obstruction,1 case of the reactive hyperplasia of lymph node around gallbladder and 1 case of gallstone. The results of MRCP were compared with surgical findings and pathology or clinical diagnosis. Breath-hold HASTE sequence was used. The source images were reconstructed by using three-dimensional(3D) maximum-intensity-projection(MIP) algorithm. Results MRCP examination succeeded in all 29 patients and the pancreaticobiliary duct was shown satisfactorily in 27 cases.The accuracy of MRCP in the detection of the level of extrahepatic bile duct obstruction was 100% and the accurary for evaluating the causes of obstruction was 79.3%. Conclusion MRCP examination has a high successful rate and can accurately define the level of extrahepatic bile duct obstrction. Combinong with the source images and routine MRI scanning for analysis, the specificity for the diagosis of extrahepatic bile duct stone and malignant biliary obstruction is also high. MRCP may substitute for diagnostic diect cholangiopancreatography and provide an optimal alternative,especially when diagnostic ERCP and PTC are unsuccessful and inadequate.