肝外胆管梗阻性疾病的MRCP诊断价值

目的探讨磁共振胆胰管成像技术对肝外胆管梗阻性疾病的诊断价值。方法对52例经病理或随访证实的肝外胆管梗阻性疾病患者的MRCP资料进行回顾性分析,总结良恶性肝外胆管梗阻的不同MRCP表现。结果52例中,MRCP均能够准确测定胆管扩张程度和梗阻的水平,其中良性梗阻27例,MRCP主要表现为胆管均匀扩张及逐渐狭窄,肝外胆管较肝内胆管扩张明显,肝内胆管呈“枯树枝状”;恶性梗阻25例,MRCP主要表现为胆管截断,胆胰管扩张,出现“双管征”,肝内外胆管扩张一致。恶性梗阻患者的肝内外胆管扩张程度明显大于良性梗阻者。结论MRCP作为一种无创的影像检查方法,对肝外胆管梗阻性疾病的诊断具有较高准确性,

The diagnosis value of MRCP in the extrahepatic biliary obstruction diseases

Objective:To analyze the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) for extrahepatic biliary obstruction.Methods:MRCP images of 52 patients with extrahepatic biliary obstruction disease were retrospectively reviewed to conclude the lumen morphological abnormalities of benign versus malignant bile duct obstructions,which were confirmed by pathology and clinic observation.Results:MRCP could correctly identify the degree of ductal dilatation and the level of obstruction in all cases.The bile duct of 27 cases of benign biliary obstruction presented regular and symmetric dilation,gradual tapering.The dilatation degree of extrahepatic bile duct was significantly bigger than that of intrahepatic bile duct,the dead-wood sign was seen in intrahepatic bile duct.The bile duct of the 25 cases of malignant biliary obstruction presented abrupt narrowing or inerruption,dilatation,and had double-duct sign.The dilatation degree of extrahepatic bile duct was same as intrahepatic bile duct.The dilatation degree of extrahepatic and intrahepatic bile duct in malignant biliary obstruction group was more serious than that in benign biliary obstruction group.Conclusion:MRCP is the noninvasive technique of choice with high accuracy for patients with extrahepatic biliary obstruction disease.