MRCP在肝外胆管梗阻中的诊断价值

Clinical Value of Magnetic Resonance Cholangiopancreatography in Evaluation of Extrahepatic Biliary Obstruction

目的 探讨磁共振胰胆管成像(magnetic resonance cholangiopancreatography, MRCP)技术在肝外胆 磁共振水成像 肝外胆管梗阻中的诊断价值。方法 收集我院2004年收治的42例胆管梗阻患者的ＭＲＣＰ检查临床资料,分析良、恶性肝外胆管梗阻在ＭＲＣＰ上的不同表现。结果 ＭＲＣＰ检查在30例良性梗阻患者主要表现为胆管均匀扩张及逐渐狭窄,管壁均匀增厚,断端可呈“鸟嘴样”,其在良性梗阻中的定位及定性准确率分别为100%(30/30)和97%(29/30);12例恶性梗阻患者中主要表现为胆管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”,其在恶性梗阻中的定位及定性准确率分别为100%(12/12)和92%(11/12)。结论 ＭＲＣＰ是一种无创性显示胰胆管管腔形态学改变的影像学方法,在评价肝外胆管梗阻中具有较好的定位及定性准确率。

Objective To evaluate the clinical value of magnetic resonance cholangiopancreatography (MRCP) in diagnosis of extrahepatic bile duct obstruction. Methods MRCP images of 42 patients presented clinically with obstructive jaundice were retrospectively reviewed to assess the lumen morphological abnormalities of benign versus malignant bile duct obstructions, with clinical pathological correlation. Results The bile duct of the 30 cases of benign biliary obstruction presented regular and symmetric dilation, gradual tapering,regular thickening and had a “beak like” tip. The accuracy of MRCP for evaluating the site and the etiology of the benign biliary obstruction were 100%(30/30) and 97%(29/30) respectively. The bile duct of the 12 cases of malignant biliary obstruction presented irregular and asymmetric dilation,abrupt narrowing or iterruption,irregular thickening and had “dual duct sign”. The accuracy of MRCP for evaluating the site and the etiology of the malignant biliary obstruction were 100%(12/12) and 92%(11/12) respectively. Conclusion MRCP is the noninvasive technique of choice with excellent accuracy for the evaluation of obstructive biliary pathology.