双管征与四管征在磁共振胰胆管成像中的诊断价值

目的：探讨MRCP征象中双管征与四管征对十二指肠乳头癌与胰头癌的鉴别诊断价值。方法：用Marconi 1．5T磁共振成像仪对114例拟诊十二指肠乳头癌或胰头癌患者进行常规MRI及MRCP检查。结果：本组114例中十二指肠乳头癌48例，胰头癌66例，均经手术和／或病理证实。MRCP表现为肝内胆管扩张呈“软藤征”占82．5％（94／114）；82．6％（71／86）的十二指肠乳头癌或胰头癌显示“双管征”，42．4％（28／66）的胰头癌显示为“四管征”。结论：MRCP图像中“软藤征”、“双管征”是恶性梗阻性黄疸的常见征象；“四管征”为胰头癌的一个特异性征象。

Diagnostic value of double-duct-sign and four-segment-sign in MR cholangiopancreatography

Objective To investigate the double-duct-sign and four-segment-sign in MR cholangiopancreatography (MRCP) in differential diagnosis of ampullary carcinoma and pancreatic carcinoma. Methods MRCP and conventional MR imaging were performed in 114 patients with ampullary carcinomas or pancreatic carcinomas on a 1.5T MR scanner. Results In 114 patients, 66 were pancreatic carcinomas and other 48 were ampullary carcinomas. Final diagnosis was proved by surgical and/or histopathological results. The vine-sign was seen in 82.5% (94/114) patients. The double-duct-sign was seen in 82.6% (71/86) patients with pancreatic carcinomas or ampullary carcinomas, the four-segment-sign was seen in 42.4% (28/66) patients with pancreatic carcinomas. Conclusion The vine-sign and double-duct-sign in MRCP are very important in diagnosis of malignant obstructive jaundice. The four-segment-sign can be regarded as a specific MRCP sign of pancreatic carcinomas.