核磁共振胆胰管成像对诊断胆道梗阻疾病的价值

MR CHOLANGIOPANCREATOGRAPHY FOR DIAGNOSIS OF BILIARY OBSTRUCTIVE DISEASES

目的 探讨核磁共振胆胰管成像（ Ｍ Ｒ Ｃ Ｐ）对胆道梗阻疾病的临床诊断价值。方法 对２１ 例结石、壶腹肿瘤、胰头癌、胆管癌及肝外胆管外压病人进行 Ｍ Ｒ Ｃ Ｐ，并对照手术病理结果及部分 Ｅ Ｒ Ｃ Ｐ结果分析。结果 ①因梗阻部位和程度不同， Ｍ Ｒ Ｃ Ｐ对胆胰管各部的显示率为８５．９％ ～１００％ ；②扩张胆管多表现为枯枝样、软藤样、腊肠样；③梗阻端呈倒杯口状、截断状、乳头状、串珠状、鼠尾样；④本组 Ｍ Ｒ Ｃ Ｐ定位诊断率为１００％ ，定性诊断率为７１．４３％ 。结论 Ｍ Ｒ Ｃ Ｐ对胆道梗阻疾病的定位诊断准确，结合源像对结石的定性诊断特异性最高，对存在完全梗阻，高度狭窄的非结石病因的鉴别尚待进一步研究。

Objective To evaluated the clinical diagnosis value of biliary obstructive disease by MRCP.Methods 21 patients with choledocholythiasis,pancreatic head carcinoma,biliary tract carcinoma,and biliary stricture were examined by MRCP.The results of MRCP were analysed. Results The demonstrating rated of each parts of cholangiopancreatic duct were 85.71-100%,Diagnostic rate of MRCP for obstructive level was 100%,the specificity for the cause of obstruction was about 71.43%.Conclusion MRCP can accurately define the obstructive site in biliary obstructive diaeases.The specificity for the diagnosis of choledocholithiasis is very high,but it specificity for the diagnosis of other diseases needs further research.