磁共振胰胆管成像对胆道梗阻性疾病定位与定性诊断的价值

目的：探讨磁共振胰胆管成像（MRCP）对胆道梗阻性疾患定位和定性诊断的价值。方法：对85例梗阻性黄疸病人的MRCP进行分析，并与CT、US、直接胆道造影和临床手术病理结果对照。结果：全部病例MRCP检查均一次成功，其中48例行直接胆道造影，与MRCP对照，二者所获图像极其相似。且对ERCP或PTC显示不完全的病例MRCP可补充有价值的诊断信息。MRCP对梗阻定位诊断准确率为100％。对梗阻定性诊断准确率为89．4％，结合MRI可提高至95．3％。结论：MRCP对梗阻性黄疸定位诊断与定性诊断准确率均高于CT及US。MRCP图像与直接胆道造影图像基本一致。方便易行无损伤，应列为胆道梗阻性疾病的术前常规检查方法。

Value of MR Cholangiopancreatography in Diagnosis of Obstruction Jaundice

Objective To evaluate the clinical value of MRCP in demonstrating the site and morphology of the biliary obstruction and to correlate the MR findings with CT,US,direct cholangiography,surgery and pathology. Methods Eighty five patients with clinical signs of biliary obstruction underwent MRI and MRCP. Results The images of MRCP were essentially identical to those of direct cholangiography. Identical diagnoses were made by both techniques relying on the satisfactory MRCP images. More valuable information could be obtained by MRCP in patients with inadequate direct cholangiography. The accuracy of MRCP in evaluating the site of obstruction was 100%. The accuracy in evaluating the nature of obstruction was 89.4%,and could increase to 95.3% in combination with MRI. Conclusion The diagnostic accuracy of MRCP in evaluating the site and nature of biliary obstruction is superior to that of US and CT.The images of MRCP are essentially identical to those of direct cholangiography.