661例MRCP图像分析

目的探讨磁共振胆胰管造影(MRCP)对胰、胆管疾病的临床定位、定性诊断价值。方法用Marconi 1.5 T超导型磁共振成像仪对661例疑有胰、胆管病变的患者进行常规磁共振成像(MRI)及MRCP检查。结果MRCP能清晰、直观、立体地显示胰、胆管的解剖结构,对胆道梗阻程度和梗阻部位的确诊率达100%。恶性梗阻性黄疸患者的肝内外胆管扩张程度明显大于良性梗阻性黄疸患者(P<0.05)。76.3%(103/135)的恶性黄疸出现“软藤征”,72.5%(50/69)的胆管癌出现“空虚征”,82.6%(19/23)的十二指肠乳头癌出现“双管征”,39.5%(15/38)的胰头癌出现特征性的“四管征”。结论“软藤征”、“空虚征”和“双管征”是恶性梗阻性黄疸的重要MRCP征象,“四管征”可作为胰头癌的特异性征象,“枯树枝征”是良性梗阻性黄疸的重要MRCP征象。

Analysis of MRCP signs on 661 cases

Objective To investigate the diagnostic value of magnetic resonance cholangiopancreatography(MRCP) in determinating the location and nature of pancreaticobiliary duct diseases.Methods MRCP and conventional MR images were performed in 661 cases suspicious of pancreaticobiliary duct diseases on a superconductive MR scanner(Marconi medical systems Inc.Eclipse.1.5-T).Results The pancreaticobiliary duct were visualized clearly and intuitionistic stereograph could be achieved with the help of MRCP.The accuracy of MRCP in the detection of bile duct obstruction was 100%.The dilatation degree of extrahepatic and intrahepatic bile duct in malignant obstructive jaundice group was significantly bigger than that in benign obstructive jaundice group((P<)(0.05)).The vine-sign was seen in 76.3%(103/135)malignant jaundice patients,the void-sign was seen in 72.5%(50/69)patients with bile duct carcinomas,the doubleduct-sign was seen in 82.6%(19/23)patients with duodenal papilla carcinomas,the specific four-duct-sign was seen in 39.5%(15/38)patients with pancreatic carcinomas.Conclusion The vine-sign,void-sign and double-duct-sign are very important MRCP signs of malignant obstructive jaundice.The four-duct-sign can be regarded as a specific MRCP sign of pancreatic carcinomas.The deadwoodsign was a specific indicator in MRCP of benign obstructive jaundice.