磁共振胆胰管成像显示分支胰管扩张的意义

Diagnostic value to depict branch pancreatic ducts dilatation by MR cholangiopancreatography

目的 探讨分支胰管扩张的磁共振胆胰管成像（MRCP）表现及其对胰腺疾病的诊断价值。资料与方法 MRCP使用Signa Excite HD3.0T MR设备,研究对象为MRCP影像显示分支胰管扩张的病人,包括慢性胰腺炎45例与胰腺癌30例,所有病人均进行常规横断面T1WI、T2WI和MRCP。分析分支胰管扩张的形态、部位及程度,比较2组疾病分支胰管扩张的差异。结果 在形态方面,慢性胰腺炎组分支胰管扩张呈小囊状、分支状及两者兼有的病例数分别为19、42和16例;而胰腺癌组分别为6、29和5例。在部位方面,慢性胰腺炎组分支胰管扩张位于主胰管近段、远段及全程的病例数分别为0、10和35例;而胰腺癌组分别为1、12和17例。结论 3.0T MRCP能清晰显示主胰管及扩张的分支胰管。认识分支胰管扩张的特征有助于慢性胰腺炎和胰腺癌的鉴别诊断。

Objective To evaluate the diagnostic value of depicting dilatation of branch pancreatic ducts （BPD） in patients with chronic pancreatitis and pancreatic carcinomas in MR cholangiopancreatography. Methods Fourty-five patients with chronic pancreatitis and thirty patients with pancreatic carcinomas were enrolled in the study. All the patients underwent MRI using axial T1 weighted imaging, T2 weighted imaging and MR cholangiopancreatography in a 3.0 T MR unit, and dilatation of BPD was analyse by which their morphology, location and extent of dilatation. Results Morphologically, dilatation of BPD in cystic, dendroid manner or both of them were seen in 19, 42 and 16 cases in chronic pancreatitis, and 6, 29 and 5 cases in pancreatic carcinomas, respectively. In location, dilatation of BPD in proximal, distal or full coverage of main pancreatic duct were seen in 0, 10 and 35 cases in chronic pancreatitis, and 1, 12 and 17 cases in pancreatic cancinomas, respectively. Conclusion Dilatation of BPD and main pancreatic duct could be well visualized in MR cholangiopancreatography at 3.0 T. It is helpful in differentiating chronic pancreatitis and pancreatic cancimoma to be familiar with leatures of dilatation of BPD.