磁共振胰胆管成像的临床诊断评价

The Diagnostic Significance of MR Cholangiopancreatography

目的:总结300例磁共振胰胆管成像(MRCP),评价诊断价值,提出MRCP“断桥”征是诊断肝门胆管癌的特征。方法:收集5年来连续性所做的300例MRCP。使用东芝公司1.5T MR机。所有病人均先行B超或CT,MR常规采用横轴位T1WI,T2WI,2D FASE,3D FASE。必要时加做T2WI压脂序列和横轴位薄层无间隔扫描。结果:300例中图像质量达优级占75%,一般占23%,差占2%。98%能满足临床诊断。MRCP中不论是2D FASE或3D FASE均必须结合MR平扫以及实时分析3D FASE原始图像,才能获得全面的诊断信息。结论:MRCP已成为诊断胰胆管疾病的重要方法,并逐渐替代诊断性的PTC和ERCP。

Objective： To evaluate the diagnostic accuracy of MRCP of 300 cases and to confirm “Break brigde” sign on MRCP as a characteristic of the porta hepatis cholangiocareinoma. Methods： Three hundred cases were continually performed within recent 5 years in our hospital. Ultrasound or CT were performed then for MR examination including axial T1WI, T2WI, 2D FASE, 3 D FASE and fat-saturated sequence, axial thin section scan. Results： The images of quality were classified into three grades. The excellent grade existed in 224 cases （75%）, general grade 69 cases（23%） ,poor grade 7cases （2%）. MRCP must integrate with MR scan and original images of 3D FASE with real time. Conclusion： Our study showed that MRCP had a diagnostic accuracy similar to that of diagnostic ERCP and PTC. It would be potential to replace invasive ERCP and PTC in the diagnosis of bile duct disease.