阻塞性黄疸的低场MRI诊断价值57例分析

The Value of MRI in the diagnosis of Obstructive Jaundice

目的探讨低场MRI对阻塞性黄疸的诊断价值。方法回顾性分析经手术病理证实或临床资料完整的57例阻塞性黄疸的MRI表现和临床资料。结果胆管扩张4例,其中轻度扩张(累及肝叶某段肝管)23例,中度扩张(累及某一肝叶)11例,重度扩张(累及整个肝叶)7例。胆总管扩张38例,其中远端高信号环逐渐变小21例,环形突然中断6例。胆囊扩大22例,胆囊壁增厚9例,胆囊腔内肿块3例,胆囊结石18例。肿块性病变,来源于肝门区10例,胰腺头壶腹部14例,难以明确部位的肿块5例。胆总管结石22例,其中胆总管内结节样低信号17例,泥沙样信号5例。其他总胆管及胰管扩张6例,胰腺钙化2例,肝硬化腹水1例。结论低场MRI对阻塞性黄疸的诊断有重要价值。它能显示梗阻的程度、阻塞的部位及病因,因而对指导临床治疗及术后评估能提供可靠的依据。

Objective To determine the value of magnetic resonance imaging （MRI） in the diagnosis of obstructive jaundice. Methods Retrospective analysis of 57 obstructive jaundice patients presentation in MRI and clinic references. Results In those cases, there are 41 dilatations of the patients＇ bile duct, including slight dilatations （n=23 ,involve in some hepatic duct of liver lobe）, medium dilatations （n=11, involve in some lobe of liver）, serious dilatations （n=7, involve in whole of liver lobe）. And there were 38 cases of choledochectasia in,including distant high signals link decreased gradually （n=21）, signals link broken suddenly （ n=6 ）, and 22 expansion of the gallbladder, including thick of the gallbladder wall （9 cases）, tumor in gallbladder （3 cases）, cholecystolichiasis （18 cases）. Tumor comes from porta hepatis （10 cases） and hepatopancreatic ampulla （14 cases）,and the tumor which it is hard to make sure the part （5 cases）, choledocholithiasis （18 cases）, including nomenclature, signal （n=17） and silt signals （n=5） in common bile duct,and dilatations of common bile duct and pancreatic duct（6 cases）, calcification in pancreas（2 cases）, cirrhosis （1 case）. Conclusion It is very important to the value of MRI in the diagnosis of obstructive jaundice. It is very important to direct the clinic treatment ,as it can demonstrate the degree and the part and pathogeny of the obstruction.