磁共振胆道造影在胆道梗阻定位和定性诊断中的价值

The value of MR cholangiography in diagnosis of bile duct obstruction

目的：通过ＭＲＩ胆道造影（ＭＲｃｈｏｌａｎｇｉｏｇｒａｐｈｙ，ＭＲＣ）与ＣＴ、ＵＳ、经皮穿刺胆道造影术（ＰＴＣ）或内窥镜逆行胰胆管造影术（ＥＲＣＰ）及手术、病理的对照研究，评价ＭＲＣ显示胆道梗阻部位，确定梗阻原因的能力。材料与方法：３０例梗阻性黄疸的患者在ＧＥＳｉｇｎａ１．５Ｔ超导系统上进行了ＭＲＣ检查，并与ＰＴＣ或ＥＲＣＰ、ＣＴ、ＵＳ、手术及病理对照。结果：本组资料中，ＭＲＣ显示胆道梗阻的部位准确性达１００％，优于有损伤性的ＰＴＣ或ＥＲＣＰ。ＭＲＣ确定梗阻原因的准确性达７０％，类似于ＰＴＣ或ＥＲＣＰ、ＣＴ、ＵＳ。结论：初步研究结果表明，无损伤性的ＭＲ胆道造影在梗阻性黄疸的定位和定性上具有很高的敏感性、准确性，对于梗阻性黄疸，特别是行ＥＲＣＰ失败和不宜行ＰＴＣ或ＥＲＣＰ的病人是最有效的替代方法。

Purpose: Magnetic resonance cholangiography (MRC) was compared with CT, US, PTC, ERCP, surgery and pathology to evaluate the accuracy of MRC in demonstrating the site and causes of bile duct obstruction. Materials and methods: Thirty patients with clinical biliary obstruction underwent MRC with GE singna 1.5T. Their rusults were compared with other diagnostic modalities. Results: The accuracy of MRC for evaluating the site of obstruction was 100%. The results were superior to direct cholangiography, CT, US. The accuracy for evaluating the cause of obstruction was 70%, which was same as that direct of cholangiography and CT, US. Conclusion: MRC is a noninvasive technique with excellent accuracy in the diagnosis of bile duct obstruction and its causes. It is an effective substitute methods for patients of clinically suspected bile duct obstruction and especially those of unsui table for PTC、ERCP.