胰胆管扩张的MRCP表现对胰腺癌和慢性胰腺炎的诊断意义

目的 研究胰胆管扩张对胰腺癌和慢性胰腺炎的诊断价值。方法 回顾性分析45例胰腺癌和41例慢性胰腺炎的MRCP资料。结果 胰腺癌组的MRCP主要特征包括：(1)胰管扩张多呈管腔光滑，明显扩张，并多在胰头肿块处截断(26例，占74．3％)；(2)扩张的胆总管多呈突然截断(26例，占89．7％)；(3)双管征(28例，占62．2％)。慢性胰腺炎组的MRCP主要特征：(1)胰管扩张多呈粗细不均的不规则型，并贯通病变(18例，占60．0％)，部分可见胰管结石(6例，占14．6％)；(2)扩张的胆总管由上至下逐渐变细(18例，占90．0％)。结论 胰胆管MRCP表现的形态特征对胰腺癌和慢性胰腺炎的诊断有鉴别意义。

MRCP characteristics of pancreaticobiliary duct dilation:significance in diagnosis of pancreatic carcinoma and chronic pancreatitis

Objective To study the diagnostic value of pancreaticobiliary duct dilation on MRCP for pancreatic carcinoma and chronic pancreatitis. Methods MRCP findings in 45 cases of pancreatic carcinoma and 41 cases of chronic pancreatitis were retrospectively analyzed. Results MRCP characteristics in carcinoma group included: (1) abrupt interruption of the continuously dilated the pancreatic duct at the site of the tumor and the lumen looking smooth (n=26,74.3%);(2) abrupt interruption of the dilated common bile duct at site of the tumor(n=26,89.7%);and (3)double-duct sign(n=28,62.2%). MRCP characteristics in pancreatiti group included: (1)irregular dilatation of the pancreatic duct across the whole segment of the lesion (n=18,60.0%);(2) stones within the pancreatic duct( n =6,14.6%);and (3)tapering of the dilated bile duct in the region of pancreatic head ( n =18,90.0%). Conclusions MRCP characteristics of pancreatobiliary duct dilation are of great significance in differential diagnosis of pancreatic carcinoma and chronic pancreatitis.