磁共振胰胆管成像在胰胆管疾病诊断中的应用探讨

Applical search of MR cholangiopancreatography in the diagnosis of pancreaticobiliary duct diseases

目的：探讨磁共振胰胆管成像（ＭＲＣＰ）在胰胆管疾病诊断中的临床应用价值。方法：５４例胰胆管疾病病人行ＭＲＣＰ检查，同时行磁共振常规扫描。６例病人在ＭＲＣＰ检查后一周内行ＥＲＣＰ检查。１４例经手术和病理证实。ＭＲＣＰ采用重度Ｔ２加权ＴＳＥ快速成像序列，加用脂肪压抑技术，图像经三维最大信号强度投影（ＭＩＰ）后处理。结果：冠状位ＭＲＣＰ图像与ＥＲＣＰ图像相似，空间分辨率略逊于ＥＲ－ＣＰ，能较好地显示胰胆管疾病的病变部位、梗阻程度及梗阻两端的情况。结论：ＭＲＣＰ作为一种安全非侵入性影像学诊断技术，能较好地显示胰胆管系统的解剖和病理变化，无放射性损伤，不用造影剂，对ＥＲＣＰ检查失败者或显示不完全的病例ＭＲＣＰ能获得较为满意的胰胆管图像。与ＥＲＣＰ相辅相成。

Purpose:To evaluate the clinical applical value of MR cholangiopancreatography (MRCP) in the diagnosis of pancreaticobiliary duct diseases.Methods:54 Pitients with pancreaticobiliary duct deseases underwent MRCP and MRI,6 Patients underwent ERCP in a week after MRCP.14 patients were confirmed by operation and pathology.Heavily T2 weighted MRCP was performed with turbo spin echo (TSE) pulse Sequence and fat suppression pulse aid.The resulting slices were then projected into a composite image using 3D a standerd maxium intensity projection (MIP) algorithm.Results:The coronal images of MRCP were similar to that of ERCP,the spicial resolution was slightly inferior to that of ERCP in fect.MRCP can better display the site,degree and the two end of obstraction in pancreaticobiliary duct diseases.Conclusion:As a safe noninvasive diagnositic technique of imaging,MRCP can better display the anatomy and pathologic changes of pancreaticobiliary duct with no requering iodinated contrast materias,no radioiogic damage.More satisfactory imagies of pancreaticobiliary duct could be obtained by MRCP in the pitients with unsucceeful or inadequate ERCP.Cooperating with ERCP each other,MRCP can improve the dignostic level of pancreaticobiliary duct diseases.