面积测量法MR胰胆管水成像在梗阻性黄疸病因诊断中的应用价值研究

The study of the method of MRCP with area measurement in aetiological diagnosis of obstructive jaundice

目的：探讨面积测量法胰胆管水成像（MRCP）在梗阻性黄疸病因诊断中的应用价值。方法：对33例梗阻性黄疸患者禁食6~8h空腹行MRCP及多层螺旋CT检查,在每个患者MRCP及CT图像的标准轴位上,取相同长度扩张或狭窄的病变胆管,分别测量其截面积的最大值与最小值,并计算最大值与最小值的比值,命名为相对扩张度,将两组数据进行统计学分析。结果：33例中,良性梗阻10例,其中结石7例,炎性狭窄3例。恶性梗阻23例,其中肝门癌3例,胆管中段癌3例,胆管下段癌4例,胰头癌5例,壶腹癌8例。MRCP和CT两组截面积的最大值与最小值的差值经统计学处理,有显著差异;最大截面积之间的差值、最小截面积之间的差值以及相对扩张度之间的差值经统计学处理,无显著差异。结论：面积测量法MRCP在梗阻性黄疸病因诊断中具有很高的应用价值,相对扩张度可以反映病变胆管扩张与狭窄的程度,把影像特征数据化,对梗阻性黄疸的病因诊断具有临床意义。

Objective：To discuss the value of the method of MRCP with area measurement in causing diagnosis of obstructive jaundice.Methods：33 patients with obstructive jaundice underwent MRCP and multi-slice CT examination after fasting 6～8 hours,then the maximum and minimum cross-sectional areas of every patient were separately measured down the same length of bile duct with expansion or stenosis in standard axial image of MRCP and CT,and then were calculated the ratio of the maximum and minimum areas,which was named as ＂relative expansion degree＂.Then the two groups of data were analysed by statistic methods.Results：Of 33 cases,10 cases were diagnosed as benign obstruction,including 7 of stone,3 of inflammatory stenosis;23 cases were diagnosed as malignant obstruction, including 3 of hilar carcinoma,3 of middle bile duct cancer,4 of lower bile duct cancer,5 of pancreatic head carcinoma,8 of ampullary carcinoma.After statistic analysis,the difference between the maximum and minimum area respectively from MRCP and CT was significant,the difference between the maximum ones,but the difference between the minimum ones and the difference between the relative expansion degree were not significant.Conclusion：The method of MRCP with area measurement is regarded as high application value in aetiological diagnosis of obstructive jaundice,the relative expansion degree can not only reflect the extent of bile duct expansion or stenosis,and digitize the image feature,and but also has clinical significance for causing diagnosis of obstructive jaundice.