磁共振胰胆管成像在胆道梗阻性疾病诊断中的价值

目的]探讨磁共振胰胆管成像（MRCP）对胆管梗阻性疾病的诊断价值.方法]选择经内镜下逆行胰胆管造影术（ERCP）和外科手术病理证实的胆管梗阻性疾病患者65例,分析其MRCP影像特征,并与病理诊断结果对照.结果]65例患者MRCP检查全部成功,胰胆管显示良好,其中,胆道轻度扩张22例,中度扩张30例,重度扩张13例;与术后病理结果对照,MRCP检查诊断胆总管结石的符合率为94.6%（35/37）,漏诊2例;炎性狭窄的符合率为61.5%（8/13）,5例误诊为恶性胆道梗阻;恶性胆道梗阻的符合率为100%（15/15）,总符合率为89.2%（58/65）.结论]MRCP对胆道梗阻性疾病诊断的价值高,值得临床推广应用.

Value of Magnetic Resonance Cholangiopancreatography in the Diagnosis of Biliary Obstructive Disease

Objective]To explore the value of magnetic resonance cholangiopancreatography（MRCP） in the diagnosis of biliary obstructive disease. Methods] Totally 65 patients with biliary obstruction verified by ERCP and surgical operation were selected. The imaging features of MRCP were analyzed retrospectively and compared with pathological diagnosis results. Results]MRCP was successfully performed for all 65 patients and showed that pancreatic and biliary duct were good. Among them, 22 cases were mild expansion of biliary tract, and 30 cases were moderate expansion, and 13 cases were severe expansion. Compared with the postop- erative pathological results, the diagnostic accordance rate of MRCP for common bile duct stone was 94.6% （35/37） and there were 2 cases with missed diagnosis. The diagnostic accordance rate of MRCP for inflammatory stricture was 61.5 % （8/13） and 5 cases were misdiagnosed as malignant biliary obstruction. The diagnostic accordance rate of MRCP for malignant biliary obstruction was 100 % （15/15）. Total accordance rate was 89.2% （58/65）. Conclusion] MRCP for the diagnosis of biliary obstructive disease has high value, so it is worthy of clinical application.