磁共振胰胆管成像对胰腺分裂诊断价值的评估

目的 评价磁共振胰胆管成像(MRCP)对胰管的显示能力和对胰腺分裂的诊断价值。资料与方法 回顾108例行MRCP检查的图像，分别观察各序列图像对胰管的显示能力和胰腺分裂在MRCP图像上的表现。结果 108例的MRCP图像，于冠状位或斜冠状位厚层TSET2WI图像有70．4％(76／108)的胰管全程显示清晰；于HASTE序列薄层冠状位或斜冠状位图像有76．9％(83／108)的胰管全程显示清晰；HASTE序列薄层横断位图像有63％(68／108)的胰管全程显示清晰；综合3个序列图像有85．2％(92／108)病例胰管全程显示清晰；99．1％(107／108)的病例胰管大部分显示清晰；冠状位薄层图像对胰头部胰管显示较好。在108例中11．1％(12／108)的病例诊断为胰腺分裂；其中5例诊断为不完全性胰腺分裂。12例胰腺分裂中有1例因胰腺分裂合并有反复发作性腹痛。结论 MRCP作为一种无创伤性检查，对胰管有很好的显示能力；对胰腺分裂可作出明确诊断，对胰腺分裂合并有不明原因反复发作性腹痛或急性胰腺炎反复发作病例的治疗有指导意义。

Evaluation of MRCP in the Diagnosis of Pancreatic Division

Objective To evaluate magnetic resonance cholangiopancreatography (MRCP) in visualizing pancreatic ducts and in diagnosing pancreatic division. Materials and Methods MRCP findings of 108 subjects were retrospectively analyzed. The influence of different sequences on the detection of pancreatic ducts and the MRCP signs of pancreatic division were observed. Results Of 108 cases, the total pancreatic duct was well displayed in 76 (70.4%) on coronal or oblique-coronal TSE T 2WI thick slice, in 83 (76.9%) on coronal or oblique-coronal HASTE SE thin slice, and in 68 (62%) on axial HASTE thin slice. When the above three sequences were combined together, a total of 92 cases (85.2%) showed whole pancreatic duct and 107 cases (99.1%) showed most part of the pancreatic duct. The coronal thin slice image could well demonstrate the duct of the pancreatic head. The diagnosis of pancreatic division was made in 12 cases (11.1%), of which 5 were incomplete and one was clinically accompanied with repeated attack of abdominal pain.Conclusion As a non-invasive technique, MRCP can clearly display the pancreatic duct and, thus, clarify the presence or absence of pancreatic division. MRCP is also helpful in guiding the clinical management for the patients of pancreatic division who presents repeated attacks of abdominal pain or acute pancreatitis of unknown reason.