MRCP在肝外胆管梗阻中的诊断价值

目的：分析MRCP在肝外胆管梗阻中定位和定性诊断的临床价值。方法：选取2007年5月-2013年5月本院收治的22例肝外胆管梗阻患者作为研究对象，采用回顾性的方式分析患者的临床资料，统计MRCP检查结果。结果：肝外胆管梗阻包括良性梗阻和恶性梗阻，在本组良性16例，恶性6例，两种类型的临床表现各不一样。其中，良性梗阻主要表现为壁正常或均匀增厚，管腔均匀扩张，并且不断的变窄，管断端逐渐移行，其改变的形状为“鸟嘴样”；而恶性梗阻主要表现为管腔不均匀对称扩张及突然狭窄或截断，管壁不均匀增厚，可出现“双管截断征”。本组调查结果显示，通过MRCP检查，所有患者的胆管梗阻部位均能准确的显示，定位准确率达100%。良性梗阻患者的检测结果显示，单纯MRCP定性有15例准确，准确率为93.7%；恶性梗阻有5例定性诊断准确，准确率为83.3%。MRCP鉴别良、恶性胆管梗阻共计20例定性准确，准确率为91%。结论：MRCP定位诊断准确，定性诊断有局限性，且有一定夸大效应，需结合常规序列综合诊断。

The Diagnostic Value of MRCP in the Extrahepatic Bile Duct Obstruction

Objective：To analyze the clinical value of MRCP in the extrahepatic bile duct obstruction and qualitative diagnosis. Method：To etrospectively analyze the MRCP findings of 22 patients with bile duct obstruction of extrahepatic in our hospital. Result：Benign obstruction mainly for lumen uniform expansion and gradually narrowed,normal or uniform wall thickening,broken end gradually transitional,a＆quot;beak＆quot;change;malignant obstruction mainly for lumen uneven symmetrical expansion and abrupt narrowing or truncated,tube wall was uneven thickening,could appear＆quot;double truncation syndrome. This group of 22 patients with MRCP can accurately display the biliary obstruction site,positioning accuracy of 100%. For patients with benign obstruction,pure MRCP qualitative diagnosis rate was 93.7%（15/16）,the qualitative diagnosis rate of malignant obstruction was 83.3%（5/6）, total bile duct obstruction,qualitative MRCP in differential diagnosis of benign and malignant accuracy rate of about 91%（20/22）. Conclusion：The accuracy of MRCP diagnosis,qualitative diagnosis has limitations,and MRCP has some exaggerated effect,need to combine with conventional sequence synthesis diagnosis.