米里斯综合征的磁共振胰胆管造影诊断

目的评价磁共振胰胆管造影术(MRCP)对米里斯(Mirizzi)综合征的诊断价值。方法收集自1998年1月至2005年5月行MRCP检查并经手术证实Mirizzi综合征患者14例,其中8例术前MRCP明确诊断。结果MRCP可显示胆囊颈或胆囊管结石嵌顿的位置,肝总管狭窄、阻塞水平及程度,以及肝内胆管的扩张。本组14例患者中,术前诊断为Mirizzi综合征8例,另外6例中误诊为肝总管、胆总管结石5例,肝门部占位1例。采用McSherry分类法将14例患者分为两型:Ⅰ型6例,Ⅱ型8例。结论MRCP可提高Mirizzi综合征的术前诊断符合率,避免对胆总管的医源性损伤。

The value of magnetic resonance cholangiopancreatography to diagnose Mirizzi's syndrome

Objective To evaluate the usefulness of MR cholangiopancreatography (MRCP) in diagnosing Mirizzi′s syndrome.Methods All 14 cases were confirmed by operation,including 8 females and 6 males,aged 39~75(mean age 57.6 years).The course ranged from 4 days to 17 years.Results MRCP revealed dilation of the intrahepatic bile ducts,narrowing of the common hepatic duct,the level of obstruction and the location of gallstone in the cystic duct.Eight cases were diagnosed as Mirizzi′s syndrome preoperatively.Of another 6 cases 5 were misdiagnosed as stones of common hepatic duct and bileduct,one was misdiagnosed as hepatoportal occupying lesion.According to McSherry,6 cases belonged to type Ⅰ ,and 8 cases belonged to type Ⅱ .Conclusion MRCP can improve preoperative diagnostic accuracy in these patients with Mirizzi′s syndrome so as to avoid iatrogenic injury to the common bile duct.