磁共振胰胆管成像在胆系梗阻性病变中的诊断价值

The value of MRCP in the diagnosis of biliary obstructive diseases

目的评价磁共振胰胆管成像(MRCP)在胆系梗阻性病变中的临床应用价值。方法收集经手术病理或临床随访证实的胰胆系梗阻性病变46例,均作了厚层法及薄层法MRCP和MRI检查,39例作了FSPGRT1WI抑脂动态增强扫描,分析各类病变在MRCP及MRI上的表现。结果MRCP厚层法与薄层法各有优点,对胆管结石总的检出率为100%,对胆管炎性病变及恶性病变引起的胆管扩张显示清晰,炎性病变呈移形性扩张,肿瘤性病变呈截断征或圆锥征。结论厚层法及薄层法MRCP是诊断胆系结石的一种理想方法,结合运用MRI、动态增强扫描,对胆系炎性病变及肿瘤性病变可作出明确诊断。

Objective To evaluate the magnetic resonance cholangiopancreatography （MRCP） in the diagnosis of biliary obstructive diseases. Methods Forty-six patients with surgically and pathologically or clinic follow-up proved biliary obstructive diseases underwent MRCP and MRI with thick-slice acquisition and thin-slice acquisition. 39 patients underwent additional T1WI with fat suppression, dynamic contrast enhanced FSPGR sequence. The MRCP and MRI findings of varied lesions were analyzed. Results Thick-slice acquisition and thin-slice acquisition of MRCP technique had each advantage and defect. The accuracy rate of MRCP in detecting choledocholithiasis was 100 % . MRCP clearly revealed the pancreaticobiliary ducts of cholangitis and neoplastic diseases. The common bile duct was progressive dilation for cholangitis and was “cut off-form”or “club-form”for the neoplastic diseases. Conclusion Thick-slice acquisition and thin- slice acquisition of MRCP is an ideal examination, when combining with MRI and dynamic contrast enhanced FSPGR sequences, the cholangitis and neoplastic diseases can be correctly diagnosed.