MRI对肝外胆管梗阻的临床诊断价值

Value of extrahepatic biliary obstruction at MR Imaging

目的探讨MRI对手术证实的肝外胆管梗阻的诊断价值。方法对44例经手术证实的肝外胆管梗阻病人MRI资料进行回顾性分析,MRI包括MRCP、平扫和增强扫描。结果44例中,17例为胆管泥沙结石,9例胰头癌,2例胆总管末端炎性狭窄,4例肝门区胆管癌,2例胆囊癌,4例转移性肿瘤(3例来自胃癌,1例来自结肠癌),4例慢性胰腺炎,1例十二指肠腺癌,1例十二指肠乳头部憩室。与手术病理比较,MRI及MRCP鉴别梗阻的良恶性的敏感性、特异性、准确率分别为80%(16/20)、70%(17/24),75%(33/44)。结论MRI可明确肝外胆管梗阻的部位及鉴别梗阻的良恶性,对肝外胆管梗阻的病因诊断具有重要价值,从而为治疗提供了可靠的依据。

Objective To study the the causes of extrahepatic biliary obstruction at MRI and MRCP. Methods 44 patients of biliary obstruction were examined with MRI and MRCP, In 44 patients,27 patients were employed Routine and contrast-enhanced MRI simultaneously.44 patients all were proved smrgerically. Results In 44 cases,17 cases were biliary tract stone,2 cases were distal common bile duct imflammatory stricture,4 cases were cholangiocarcinoma of porta hepatis,2 were carcinoma of gallbladder,4 were metastatic tumor from stomach or colon ,9 were pancreatic carcinoma, 4 were chronic pancreatitis, 1 was duodenal adenocarcinoma,1 was duodenal diverticulum. Sensitivity,specificity and accuracy of differentiation of malignant from benign biliary stricture is 80% ,70% and 75%,respectively.Conclusion Routine and contrast-enhanced MRI and MRCP plays a important role in the biliary obstruction.