MRCP结合MRI在胆管癌诊断和鉴别诊断中的应用

MRCP and MRI: the application in the diagnosis and differential diagnosis of bile duct cancer

目的:讨论MRCP和MRI在胆管癌诊断和鉴别诊断中的应用。方法:回顾性分析18例胆管癌患者的MRI和MRCP表现,所有患者均行MR平扫及MRCP检查,其中4人做了MR动态增强扫描。18例中14例经手术病理证实,其余4例均经临床影像学资料全面综合分析确诊。结果:肝门部胆管癌9例,肝外胆管中段癌3例,肝外胆管下段癌6例。MRCP表现为胆管狭窄端呈不规则偏心性狭窄10例,向心性狭窄2例,阻塞或充盈缺损6例。MRI表现为扩张胆管末端不规则狭窄、软组织结节影或“双管征”,T1WI呈低、等信号,T2WI呈稍高信号,动态增强呈轻、中度强化。结论:MRCP是一种无创伤性的显示胰胆管腔形态的影像学方法,结合MR平扫加增强扫描,在胆管癌定位和定性诊断中有重要价值。

Objective：To investigate diagnostic value of MRI and MR cholangiopancreatography（MRCP） in the diagnosis and differential diagnosis of bile duct cancer. Methods： 18 eases wldch were confirmed by clinical and pathologic data were evaluated by MRCP, MR and contrast MR. Results：Of 18 cases, the pefihilar bile duct carcinomas am in 9 cases, the middle common bile carcinomas in 3 cases. distal bile duct carcinoma in 6 cases. The MRCP presented irregular and asymmetric dilation of the bile duct carcinoma in 10 cases, regular and symmetric dilation in 2 cases and abrupt interrupion in 6 cases. MRI presented irregular narrowing, thicking, soft nodes and had ＂dual-duct sign＂. T1WI shows hypodense or isodense, T2WI shows hyperdense. MRI shows slightly or moderate enhancement following administration of contrast medium. Conclusion： MRCP is the noninvasive technique for depicting the pancreatic-bile ducts. If with pre-and post-contrast MR scan, it is helpful in evaluating the site and etiology of the diagnosis of bile duct cancer.