先天性胆总管囊肿并发肝脏损害的磁共振诊断及病理分析

MR imaging diagnosis and pathologic analysis in choledochal cyst with hepatic injury

目的分析先天性胆总管囊肿并发肝脏损害的磁共振（MRI）诊断价值及病理基础。方法用SIEMENSSONATA1．5T超导磁共振扫描机，采用平均矢状位自旋回波序列（SE）T1WI，快速自旋回波序列（FSE）T2WI，True fisp（真稳态自由进动快速成像），MRCP（磁共振水成像）及二乙三胺五乙酸乳（Gd—DTPA）增强检查，回顾性分析12例先天性胆总管囊肿并发肝脏损害的MRI表现，结合手术及文献对其病理基础进行分析。结果MRI对12例先天性胆总管囊肿的定位、分型及周围结构关系与手术所见一致，其准确性、敏感性及特异性均达到100％。7例出现并发肝脏损害后肝硬化改变，占总病例的58．3％，MRI反映肝硬化的各种信号特点与病理结果相近。结论MRI作为无创性检查手段，能够对先天性胆总管囊肿的形态、部位及与周围结构关系作出准确诊断，可以对肝脏损害并发肝硬化作出较好的评价，并能反映其病理特征。

Objective To analyze MR imaging diagnostic value and pathlolgic bases of choledochal cyst with hepatic injury. Methods SE T1WI, FSE T2WI, True fisp, magnetic resonance cholangiopancreatography （MRCP） and Gd - DTPA enhanced examination were performed by siemens sonata 1.5T equipment to retrospectively analyze MR imaging findings of 12 cases with choledochal cyst complicating with hepatic injury, and analyze pathologic bases by operations and literature. Results Location, typing and surrounding structural relationship of choledochal cyst of 12 cases were coincident between MR imaging findings and operating findings with 100 percent of accurate, sensibility and specificity. Hepatic injury of 7 cases leaded to hepatic cirrhosis, which were 58.3 percent of total cases. MR imaging of hepatic cirrhosis could display a series of signal character coinciding with operating and pathologic findings. Conclusion Location, typing and surrounding structural relationship of choledochal cys can be accuratly diagnosed by MR imaging, which is better to evaluate hepatic injury complicating with hepatic cirrhosis and can indicate pathlogic character.