梗阻性黄疸患者MRCP及肝胆断层MR检查对于PTC及PTBD指导作用的分析

目的比较MRCP与PTC在梗阻性黄疸的诊断过程中的优缺点,探讨MRCP对PTC和PTBD治疗的指导作用.方法 15例梗阻性黄疸患者分别进行MRCP和PTC检查,并行PTBD介入治疗,分析图像,对两种检查方法的定位、定性诊断的正确率和对胆道显示的情况进行比较.结果 MRCP与PTC的定位诊断和定性诊断的正确率分别为:PTC 100%和80%;MRCP 100%和93%.MRCP与PTC相比在梗阻性黄疸患者中能够更好地显示肝内外胆道的情况.与MRCP检查同时进行的横断面和冠状断层图像可以准确显示胆道管腔以外的病变.在MRCP指导下,PTBD介入治疗留置引流管单纯外引流6例,内外引流9例.引流效果满意,没有严重并发症发生.结论梗阻性黄疸患者的MRCP及肝胆断层MRI检查,可以较PTC提供更多的诊断信息,并对PTBD提供有力的指导作用,减少并发症,提高手术成功率.

Analysis of pre-operative MRCP and conventional MR imaging for patients with obstructive jaundice in the guidance of PTC and PTBD

Objective To explore MR cholangiopancreatogrphy (MRCP) and percutaneous transhepatic cholangiography (PTC) in the diagnosis of obstructive jaundice and guidance of PTC and percutaneous transhepatic biliary drainage (PTBD). Methods MRCP and PTC was performed in fifteen patients with obstructive jaundice and PTBD was performed afterwards. The advantages and disadvantages were compared between these two methods. Results The bile duct were displayed better with MRCP than with PTC in patients with obstructive jaundice. The conventional MRI images could truly display the changes outside the bile duct. The interventional treatment of PTBD left with six external drainage and nine internal and external drainage. The effect of draining was satisfied without severe complication. Conclusion MRCP and conventional MRI image for the patients with obstructive jaundice could give more diagnostic information than PTC; could have guiding effect for (PTBD); reduced the complications and increased the success rate of operation.