磁共振胰胆管成像结合常规MRI成像对胰胆管良恶性病变的诊断价值

目的:观察胰胆管病变磁共振胰胆管成像（MR cholangiopancreatography,MRCP）及常规MRI影像学表现，探讨二者可能的诊断价值。方法:对58例经手术病理或综合影像证实的胰胆管病变行MRCP三维容积采集薄层重建、MRCP二维厚层块投射扫描及常规MRI扫描，分析各类病变的MRCP及常规MRI影像学表现，探讨诊断价值，总结诊断经验。结果:58例胰胆管病变中胰胆管结石28例，慢性胰腺炎9例，胰腺癌9例，胆管癌5例，肝门区淋巴结转移2例，Ⅰ型先天性胆总管扩张1例，胆囊切除术后1例，胰腺分裂1例，肝移植术后1例，恶性胰管内乳头状黏液瘤1例。胰胆管良恶性病变MRCP三维容积采集薄层重建、MRCP二维厚层块投射扫描及常规MRI扫描影像表现各异，均有各自特征表现。结论:MRCP三维容积采集薄层重建、二维厚层块扫描结合常规MRI有利于胰胆管病变的定位、定性诊断及鉴别诊断，值得在有条件的医院推广应用。

Value of magnetic resonance cholangiopanceatography combined with conventional MRI in diagnosis of pancreaticobiliary duct lesions

Objective:To observe the manifestations of magnetic resonance cholangiopanceatography (MRCP) and conventional magnetic resonance imaging (MRI) for pancreaticobiliary duct lesions. Methods: Fifty-eight patients with pancreaticobiliary duct lesions,which were confirmed by pathology and comprehensive imaging,were examined by 3D-MRCP volume scanning with thin slice reconstruction,2D-MRCP projective scanning and conventional MRI. The MRCP and MRI manifestations of different lesions were analyzed and their diagnostic values were discussed. Results: Calculus of bile duct and pancreatic duct was found in 28 patients,chronic pancreatitis in 9,pancreatic cancer in 9,carcinomas of bile duct in 5,metastases to lymph nodes of porta hepatic in 2,congenital choledochus dilatation,cholecystectomy,pancreas divisum,post liver transplantation,and malignant intraductal papillary mucinous tumor of pancreatic duct all in 1. The manifestations of 3D-MRCP volume scanning with thin slice reconstruction,2D-MRCP projective scanning and conventional MRI for pancreaticobiliary duct lesions were different and had their own characteristics. Conclusion: The combinations of 3D-MRCP volume scanning with thin slice reconstruction,2D-MRCP projective scanning and conventional MRI can help to locate and diagnose pancreaticobiliary duct lesions.