MRI结合MRCP对十二指肠乳头癌的诊断价值

Value of MRI in combination with MR cholangio-pancreatography in the diagnosis of carcinoma of duodenal papilla

目的:探讨十二指肠乳头癌的MRI和磁共振胰胆管成像(MRCP)表现及诊断价值。方法:回顾性分析经病理组织学检查证实的26例十二指肠乳头癌的MRI及MRCP表现,分析乳头区病灶、胆管扩张形态、梗阻端形态以及胆管、胰管与十二指肠之间的关系。结果:26例十二指肠乳头癌显示乳头区肿块16例,肿块T1WI呈稍低或等信号,T2WI呈等或稍高信号。MRCP示"双管征"19例,胆管均呈"软藤状"扩张,轻度扩张4例,无扩张3例;梗阻端呈"鸟嘴样"狭窄11例,截然狭窄7例,倒杯口状狭窄3例,无明显梗阻5例。结论:MRI结合MRCP可作为十二指肠乳头癌的首选检查方法。

Objective：To investigate the manifestations and the value of MRI in combination with MR cholangio-pancreatography （MRCP） in the diagnosis of carcinoma of duodenal papilla.Methods：The MRI and MRCP findings of carcinoma of duodenal papilla in 26 cases proved by pathology were retrospectively analyzed.The changes of duodenal papilla region,the dilation pattern of pancreaticobiliary duct as well as the obstruction ending of bile duct,the relationgship between pancreaticobiliary duct and duodenum were investigated.Results：Of the 26 patients having carcinoma of duodenal papilla,duodenal papillary mass could be assessed in 16/26 cases,showing relative hypo-/iso-intensities on T1WI,iso-/slightly hyper-intensities on T2WI.On MRCP images,＂double duct sign＂ was showed in 19 cases,all of the dilated biliary duct appeared as ＂soft rattan sign＂;slight dilation of biliary duct in 4 cases,no evidence of dilation in 3 cases.The end of dilated bile duct was showed as ＂beak sign＂ in 11 cases,＂cut off＂ sign in 7 cases,＂inverse cup＂ sign in 3 cases,no evidence of ductal dilation in 5 cases.Conclusion：MRI in combination with MRCP is the modality of choice in the diagnosis of carcinoma of duodenal papilla.