磁共振T_2加权像结合磁共振胰胆管成像对梗阻性黄疸的诊断价值

The utility of MR T_2WI plus MRCP in the diagnosis of obstructive jaundice

目的探讨磁共振T2加权像结合磁共振胰胆管成像(T2WI+MRCP)对梗阻性黄疸的诊断价值。方法经手术病理证实的梗阻性黄疸82例,包括胆总管结石36例,Mirizzi综合征5例,胆囊癌4例,胆管癌14例,胰头癌20例,壶腹癌3例,治疗前均经B超、磁共振T2加权平扫和MRCP检查,其中,73例还经CT检查。将T2WI结合MRCP和单独的MRCP、CT、B超的定位和定性诊断的准确率进行比较。结果T2WI结合MRCP对于梗阻性黄疸的定性诊断准确率优于单独MRCP片(P<0.05),定位诊断无差异,同时也优于CT,B超检查。结论对梗阻性黄疸的定位、定性诊断,T2WI结合MRCP可作为首选的检查方法。

Objective To evaluate the value of magnetic resonance T2 weighted imaging（MR T2WI） plus magnetic resonance cholangiopancreatography（MRCP） for diagnosing the obstructive jaundice. Methods Eighty - two patients with surgically and pathologically proved obstructive jaundice which comprised 36 choledocholithiasis, 5 Mirizzi syndrome, 4 gallbladder carcinoma, I4 cholangiocarcinoma, 20 pancreatic head carcinoma and 3 ampullary carcinoma underwent T2WI, MRCP and ultrasonography（US） before the operation. Of them, 73 cases underwent additional CT scans. The locative and qualitative accuracy of MR T2WI plus MRCP in the evaluation of obstructive jaundice were comparatively analyzed with that of single MRCP, CT and US, Results The qualitative accuracy of MR T2WI plus MRCP in the diagnosis of obstructive jaundice was significantly superior to single MRCP, CT and US（ p 〈 0.05）but there were not obvious differences between MR T2WI plus MRCP and other single MRCP, CT or US in the locative diagnosis of obstructive jaundice. Conclusion MR T2WI plus MRCP can be taken as a first selective protocol in order to diagnose obstructive jaundice.