高场强MRCP在梗阻性黄疸中医辨证分型中应用价值的研究

目的：探讨磁共振胰胆管成像（MRCP）在梗阻性黄疸中医辨证分型中的应用价值。方法：用西门子1．5T超导型磁共振成像仪对66例梗阻性黄疸患者进行常规MRI及MRCP检查，同时进行中医辨证分型，所有病例均通过手术病理、ERCP病理结果或临床综合诊断证实。结果：66例梗阻性黄疸病例中，中医辨证分型阳黄30例，主要以结石、炎症、先天囊肿为主；阴黄36例，主要以胆管癌，壶腹癌、胰腺癌为主；阴黄肝外胆管扩张程度以中、重度扩张为主，占88．9％（32／36），阳黄以轻中度扩张为主，占86．7％（26／30）；阴黄扩张胆管形态以软藤征为主，占72．2％（26／36）；阳黄以枯枝征为主，占73．3％（22／30）。结论：MRCP征象与黄疸中医证型之间存在显著相关性，高场强MRCP可为梗阻性黄疸的中医辨证分型提供有价值参考。

The Evaluation of High Strength MRCP in Syndrome Differentiation of TCM on Obstructive Jaundice

Objective： To evaluate the application value of high strength magnetic resonance cholan giopancreaticography（MRCP）for syndrome differentiation of TCM in patients with obstructive jaundice. Methods ： Routine MRI and MRCP examination on 66 patients with obstructive jaundice were performed with 1.5T Siemens super- conductive magnetic resonance machine. Each case had been classified in either syndrome differentiation of TCM .Final diagnosis were confirmed by surgical or ERCP pathology and clinic observation.Results ： Of the 66 patients,30 cases showed Yang-Huang, the main obstructive reasons of which included bile duct stones, inflammatory stenosis and congenital cyst; 36 cases showed Yin-Huang, the main obstructive reasons were bile duct carcinomas, ampullary carcinomas or pancreatic carcinomas. The dilatation degree of bile duct was more serious in cases of Yin-Huang than that in Yang-Huang . Majority of Ying-Huang presented vine-sign well dead-wood sign was more freguently found in cases of Yang-Huang. Conclusion ： The signs of MRCP had close relationgship with the syndrome differentiation of TCM.High strenghth MRCP was helpfuI in the syndrome differentiation of TCM.