低场磁共振胰胆管成像诊断胆系疾病的潜能

The potency of low field MRCP in diagnosing biliary system diseases

目的阐述低场磁共振胰胆管成像(MRCP)诊断胆系疾病的潜能。方法 70例手术病理或临床证实的胰胆疾病患者包括胆囊切除术后胆管代偿性扩张2例,胆总管直径临界值4例,胆系结石49例,胆总管炎性狭窄4例,胰头癌4例以及胆管癌7例均经低场MRCP检查。全部操作是在0.35 TSIEMENS磁共振扫描仪上采用TSE T1WI、T2WI序列和MIP重建进行的。结果本组70例中,低场MRCP正确诊断胆系结石49例,胆总管炎性狭窄4例,胰头癌4例以及胆管癌7例,其诊断敏感性100%,特异性89.8%,准确性91.4%,阳性预测值100%以及阴性预测值90.7%。结论低场MRCP是诊断胰胆疾病的一种无创、安全、高效的影像技术,尤其对恶性病变极为敏感而提示其具有广阔的应用前景。

Objective To elucidate the potency of low field magnetic resonance cholangiopancreatography（MRCP） in diagnosing biliary system diseases.Methods Seventy patients with surgically and pathologically or clinically proved pancreato-biliary system diseases which comprised compensatory dilation of bile duct secondary to cholecystectomy（n=2）,choledochal diameters reaching into critical value（n=4）,biliary system calculus（n=49）,inflammatory stricture of choledochus（n=4）,pancreatic head carcinoma（n=4）,and bile duct carcinoma（n=7） underwent low field MRCP examinations.All procedures were performed by using TSE T1WI,T2WI sequences and maximum intensity projection（MIP） reconstruction on a 0.35 T SIEMENS MR scanner.Results Among 70 patients,low field MRCP correctly diagnosed 49 biliary system calculi,4 inflammatory strictures of choledochus,4 pancreatic head carcinomas,and 7 bile duct carcinomas.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of MRCP in the group were 100%,89.8%,91.4%,100% and 90.7%,respectively.Conclusion Low field MRCP is a non-invasive,safe and high-effective imaging technique in diagnosing pancreato-biliary diseases,especially its high-sensitive for malignant lesions suggests it has wide-applied foreground.