MRCP 3D FRFSE系列对良恶性胰胆管梗阻的诊断价值

目的探讨三维快速恢复快速回波脉冲系列磁共振胰胆管水成像(MRCP 3D FRFSE)对良恶性胰胆管梗阻的临床应用价值。方法对106例临床疑有胰胆管梗阻患者行MRCP 3D FRFSE系列检查,2位高年资放射科医师前瞻性分析图像,结果与手术病理或临床随访结果比较。结果106例MRCP检查均一次性成功,肝内外胆管显示率为100%,主胰管显示率为93.4%,其中80例良性梗阻包括肝内外胆管结石66例,乳头炎6例,十二指肠降段憩室炎2例,十二指肠腺瘤样增生1例,慢性胰腺炎5例;26例恶性梗阻包括肝外胆管癌9例,壶腹癌5例,胆囊癌4例,胰头癌8例。MRCP对胰胆管梗阻的定位诊断准确率为100%,在区分良恶性梗阻中,敏感性92.3%,特异性96.3%,准确性95.3%。结论3D FRFSE系列的MRCP是区分良恶性胰胆道梗阻病变较为理想的技术,在临床上有较大的应用价值。

Evaluation of Three-dimensional Fast Recovery Fast Spin-Echo MRCP in Differentiating Benign from Malignant Causes of Biliary and Pancreatic Duct Dilatation

Objective To evaluate the diagnostic value of MR cholangiopancreatography(MRCP) using three-dimensional fast recovery fast spin-echo(3D FRFSE) in differentiating benign from malignant causes of biliary and pancreatic duct dilatation.Methods 106 cases suspected biliary and pancreatic duct dilatation underwent 3D FRFSE MRCP.The images were prospectively analysed by two skilled radiologists,and the results were compared with that of surgery,biopsy or follow-up.Results MRCP was successful performed at one time in all cases.On MRCP,the visual rate of intra-and extrahepatic bile duct was 100% and that of main pancreatic duct was 93.4%.80 patients had benign lesions: bile duct lithiasis(n=66),papillitis(n=6),descending part of duodenum diverticulitis(n=2),duodenal adenomatoid hyperplasia(n=1) and chronic pancreatitis(n=5).26 patients had malignant lesions: extrahepatic cholangiocarcinoma(n=9),ampullary carcinoma(n=5),gallbladder carcinoma(n=4) and pancreatic head carcinoma(n=8).The sensitivity,specificity and accuracy in differentiating benign from malignant causes of biliary dilatation were 92.3%,96.3% and 95.3%,respectively.Conclusion 3D FRFSE MRCP plays an important role in diagnosis of differentiating diagnosis of the causes of biliary dilatation in clinical practice.