三维磁共振胰胆管成像诊断婴儿胆道闭锁

Three-dimensional magnetic resonance cholangiopancreatography in the diagnosis of biliary atresia in infants

目的分析3D-MRCP对婴幼儿胆道闭锁的诊断价值。方法收集13例临床怀疑为胆道闭锁的患儿,所有患儿均接受3D-MRCP检查,根据MRI诊断结果,选择术中造影、腹腔镜探查或病理检查。对比分析所有患儿的3D-MRCP与术中造影、腹腔镜探查及手术病理所见。结果 MRI诊断胆道闭锁10例,胆总管囊肿2例,1例正常;术中造影诊断胆道闭锁6例、胆道狭窄1例,显影正常1例;腹腔镜诊断胆道闭锁2例;手术病理诊断为先天性胆总管囊肿2例;另有1例患儿经临床治疗后痊愈。结论 3D-MRCP可在术前有效诊断BA。如经3D-MRCP多方位观察,仍未发现完整的肝外胆道,应高度怀疑胆道闭锁。

Objective To analyze the diagnostic value of three-dimensional magnetic resonance cholangiopancreatography （3D-MRCP） for biliary atresia （BA） in infants. Methods Thirteen patients with clinical suspicion of BA underwent 3D-MRCP. They also underwent intraoperative cholangiography, laparoscopic exploration or pathological examination according to the MRI manifestations. The coincidence of the findings of 3D-MRCP with intraoperative cholangiography, laparoscopy and pathology were compared and analyzed. Results MRI diagnosed BA in 10 patients, choledochal cyst in 2 and normalness in 1 patient. With intraoperative cholangiography, BA was diagnosed in 6 patients, biliary stricture in 1 and normalness in 1 patient. With laparoscopy, 2 patients were diagnosed as BA. Two patients were diagnosed as congenital choledochal cyst with surgery and pathology. The other one cured after non-operative treatment. Conclusion 3D-MRCP is an effective imaging technology in finding BA before operation. BA should be highly suspected if extrahepatic bile duct can not be observed with 3D-MRCP.