磁共振胆胰管成像诊断小儿胆道疾病

MR Cholangiopancreatography in Diagnosis Biliary Tract Disorders of Infants and Children

目的:探讨磁共振胆胰管造影(MRCP)诊断小儿胆道疾病的临床应用价值。材料和方法:回顾性分析60例胆道疾病患儿的MR I和磁共振胆胰管成像(MRCP)表现。结果:新生儿肝炎8例,其肝内、外胆管通畅。新生儿胆道闭锁10例,未见完整肝外胆道显示,6例冠状位T2W I示肝门部限局三角形高信号影,4例门静脉周围增宽,肝门部条索状长T2信号。胆总管囊肿42例,其中Todan iⅠ型32例、Ⅱ型3例、Ⅳa型5例、Ⅴ型2例;20例显示胆胰管合流异常,其中胆-胰型13例,胰-胆型7例。结论:MRCP可以准确鉴别新生儿肝炎及先天性胆道闭锁引起的新生儿黄疸;可清楚显示胆总管囊肿及胆胰管异常合流形态。

Purpose： To evaluate the role of MR cholangiopancreatography （MRCP） in diagnosing biliary fract disorders of infants and children. Material and Methods： MRI and MRCP images were analyzed retrospectively in 60 cases infants and children suspected with biliary tract disorders. Results： The whole intra-and extra-hepatic bile duct was observed in all the 8 cases of neonatal hepatitis. For 10 cases of biliary atresia, the entire extra-hepatic bile duct could not be visualized while a triangular high signal area confined to the portal hepatis in 6 cases and peripotal thickening with irregularly high signal intensity in another 4 cases were observed. For 42 cases of choledochal cysts, MRCP not only helped to specify the anatomical type classification （Todani classification type Ⅰ 32 cases, type Ⅱ 3 cases, type Ⅳ. 5 cases, and type Ⅴ 2 cases） but also to demonstrated the anomalous junction of pancreaticobiliary duct （type Ⅰ of bile duct drained into pancreatic duct at a right angle 13 cases, type Ⅱ of pancreatic duct drained into bile duct at an acute angle 7 cases）. Conclusion： Neonatal hepatitis and biliary atresia can be differentiated accurately through MRCP. MRCP can visualize the modality of choledochal cyst and the anomalous junction of pancreaticobiliary duct.