MRI及MRCP在先天性胆管囊肿及合并症中的诊断价值

目的探讨磁共振成像（MRI）及磁共振胆胰管成像（MPCP）对先天性胆管囊肿及其合并症的诊断价值。方法回顾性分析29例经病理证实的先天性胆管囊肿患者的MRI及MRCP影像表现。结果29例先天性胆管囊肿，10例Ib型，7例Ic型表现为仅限于胆总管局限性扩张，MRCP示扩张胆总管与胆管树相通。10例IV型，2例V型表现为肝外和／或肝内及仅限于肝内多发胆管扩张，MRCP示胆管树呈多发大小不等囊柱状。合并结石7例，Ib型4例，IV型3例，表现为胆管内单发和／或多发边界清楚无强化灶。合并肿瘤3例，IV型及V型合并胆管癌各1例，表现为扩张胆管壁内强化结节；1例Ib型合并胆囊癌伴肝内多发转移。1例V型合并闭锁表现为扩张胆总管远端中断。1例VI型合并胰腺炎。MRI及MRCP能准确地做出胆管囊肿的诊断并能进行准确的分型，定位，定位准确率达100％，并能清楚显示胆管囊肿的合并症。结论MRI及MRCP检查在先天性胆管囊肿的诊断及显示其合并症中具有重要的价值。

The diagnostic value of MRI and MRCP in congealtal duct cysts and complications

Objective To investigate the value of MRI and MRCP in diagnosis of congenital duct cysts and their complications. Methods The MRI and MRCP of 29 cases of congenital duct cyst verified by pathological findings were analyzed retrospectively. Results In 29 cases of Congenital choledochocele, 10 of which are type Ib and 7 were Ic, appearing as the focal choledochal ecstasis, which were connected with the bile duct tree and displayed by MRCP. 10 cases were type IV and 2 are type V, appearing as the multiple cholangiectasis extrahepaticly and/or intrahepaticly and displayed by MRCP as the multiple cystoid with different sizes. There were 7 cases with complication of calculus, 4 in type Ib and 3 in type IV, appearing as single or multiple non-enhanced lesion with clear border. There were 3 cases with complication of tumors, 1 cholangiocarcinoma in type IV and type V respectively, appearing as the enhanced nodus within the wall of dilatant bile duct, 1 gallbladder carcinoma in type lb with multiple liver metastasis. The interruption of distal choledochocele was demonstrated in the complication of biliary atresia in 1 of type V. There was pancreatitis in 1 of type IV. The diagnosis and typing of choledochocele can be accurately made by MRI combined with MRCP, and complications were easily and clearly showed. The accuracy rate for location of choledochocele was 100%. Conclusion There is an important value for MRI and MRCP examination in diagnosis of congenital bile duct cysts and their complications.