磁共振胰胆管水成像联合扩散加权成像对梗阻性黄疸的诊断价值

目的研究磁共振胰胆管水成像联合扩散加权成像诊断梗阻性黄疸的价值。方法对随机收治的梗阻性黄疸患者215例作为研究对象,其中男127例,女88例。年龄13~86岁,平均61.7岁。所有患者在做MRCP的基础上,常规增加DWI序列,将两组检查结果进行比较。结果 215例梗阻性黄疸患者中,胆道高位梗阻85例,低位梗阻130例。胆总管结石91例,胆道炎性狭窄39例,胆管癌93例,胰头癌12例,壶腹癌8例。对梗阻性原因的诊断,单纯MRCP检查的确诊率91.4%,误诊率8.6%;MRCP联合DWI的确诊率98.8%,误诊率1.2%。两组样本的比较采用U检验,U=3.838,有显著性差异（P〈0.001）。结论对梗阻性黄疸患者进行MRCP联合磁共振扩散加权成像（DWI）扫描,诊断胆总管梗阻的原因更为准确,可以作为常规检查序列推广应用。

Usefulness of MRCP with DWI in diagnosing the obstructive jaundice

Objective To study the usefulness of magnetic resonance cholangiopancreatography（MRCP）combined withd iffusion weighted imaging （DWI） in diagnosing the obstructive jaundice. Method Two hundred and fifteen consecutive patients with obstructive jaundice,who comprised 127 men and 88 women aged 13- 88 years,mean age,61.7 were collected and studied in the group.All the patients initially underwent MRCP and then underwent additional DWI.The imaging data acquired from the both modalities were compared each other. Results The study demonstrated that there were 85 case of high- order obstruction and 130 case of low- order obstruction in 215 patients with obstructive jaundice which comprised 91 choledocholithiases,39 inflammatory bile duct strictures,93 cholangiocarcinomas,12 pancreatic head carcinomas and 8 ampullary carcinomas.For the diagnosis of the obstructive causes, the accuracy of MRCP alone was 91.4%,while the misdiagnostic rate was 8.6% but following MRCP combined with DWI, the diagnostic accuracy was increased to 98.0%, while the misdiagnostic rate was decreased to 1.2%. The comparison of the both modalities by U test,U=3.838 and was significant difference （P0.001）. Conclusion The combination of MRCP and DWI could more accurately identify cause of obstructive jaundice and should be widely used as a conventional modality.