MRCP对诊断良恶性胆道梗阻的临床应用

Clinical application of MRCP in the d iagnosis of benign and malignant bil e tract obstruction

目的评价磁共振胰胆管成像MRCP对良恶性胆管梗阻的诊断价值。方法25例经病理证实的良恶性胆道梗阻包括胆囊及胆道结石10例,单纯胆囊结石3例,胆总管囊肿合并结石1例,壶腹及胰头癌6例,肝门癌3例,以及胆囊癌2例的MRCP表现进行了回顾性分析。MRCP检查是以PHILIPSGYROSCANNT1.0磁共振成像仪并用3D-FSE序列和常规SE序列进行的。结果在所有病人中成功地进行了MRCP检查。其表现随病变性质与部位不同而异,如肝内胆管明显扩张且呈软藤状见于肝门癌。胆总管横行截断,断端形态规则见于胆管上段腺癌。胆总管明显增宽呈壶腹状,胆囊明显增大见于胆总管囊肿。结论MRCP应成为诊断良恶性胆道梗阻的推荐方法。

Objective To evaluate the value of magnetic resonance cholangio pancreatography(MRCP)in the diagnosis of benign and malignant bile tract obstructions.Methods MRCP findings in 25paticnts with pathologically proven benign and malig nant bile tract ob-structions including 13cases of cal culi of gallbladder and /or bile duct ,1cyst of common bile duct,6carcinoma of ampulla and pancreatic head,3carcinoma of porta hepatis an d 2carcinoma of gallbladder were analyzed retrospectively.MRCP examin ations were performed using3D -FSE Sequence and conventional se quence on PHILIPS GYROSCAN NT 1.0MR S canner.Results MRCP examination was successfully performed on all patients,whereas MRCP findings of bile tract obstructi ons were varied with benign or matign ant obstruction and its loeation.For example.significant ly dilated intrahepatic bile ducts a ppeared as soft -rattan form were fou nd in hilar cholangiocarcino-ma.Transverse broken and regular -s hape broken ends of common bile duct w ere found in superior bile duct segme nt carcino-ma.Significantly thickened common bile duct appeared as ampulla form an d significant enlargement of gallbl adder were found in common bile duct cyst.Conclusion MRCP should be preferred means of dia gnosing benign and malignant biliary obstruction.[