MRCP形态学分析对胰头癌和胰头部肿块型慢性胰腺炎的诊断价值

目的：探讨磁共振胰胆管成像（MRCP）形态学变化对胰头癌和胰头部肿块型慢性胰腺炎的诊断价值。方法：回顾性分析30例胰头癌与30例胰头部肿块型慢性胰腺炎患者的MRCP表现。结果：胰头癌组的MRCP特征包括：①胰管扩张25例，病灶处截断26例，远端胰管呈光滑均匀扩张21例；②胆管扩张25例，胰头处截断21例；③肝内胆管扩张24例。胰头部肿块型慢性胰腺炎的MRCP特征包括：①胰管扩张18例，病灶处胰管贯通26例，远端胰管串珠样扩张17例；②胆管扩张12例，病灶处逐渐变细10例，正常18例；③肝内胆管扩张11例；④胰管结石14例，假囊肿9例。结论：MRCP表现的形态特征对胰头癌和胰头部肿块型慢性胰腺炎的诊断有鉴别意义。

Diagnostic value of morphologic analysis of MRCP for inflammatory pancreatic mass and pancreatic cancer in the head of pancreas

Objective：To study the value of morphologic characteristics of magnetic resonance cholangiopancreatography（MRCP） in the diagnosis and differential diagnosis of inflammatory pancreatic mass（IPM） and pancreatic cancer（PC） in the head of pancreas.Methods：MRCP findings in 30 cases of IPM and 30 cases of PC were analyzed.Results：MRCP characteristics in PC group included： ①dilatation of the pancreatic duct（25 cases）,interruption in the lesion（26 cases） and continuous and smooth dilatation of the distal pancreatic duct（21 cases）;②dilatation of bile duct（25 cases）,interruption in the head of pancreas（21 cases）;③dilatation of intrahepatic bile duct（24 cases）.MRCP characteristics in IPM group included： ①dilatation of the pancreatic duct（18 cases） passing through the lesion（26 cases） and string-of-beads dilatation of the distal pancreatic duct（17 cases）;②dilatation of bile duct（12 cases）,tapering（10 cases） or normal（18 cases）;③dilatation of intrahepatic bile duct（11 cases）;④calculus of pancreatic duct（14 cases） and paeudocyst（9 cases）.Conclusion：MRCP morphologic characteristics had a great value in the diagnosis and differential diagnosis of inflammatory pancreatic mass and pancreatic cancer in the head of the pancreas.