MRCP对恶性胆道狭窄的诊断价值

The value of magnetic resonance cholangiopancreatography in the diagnosis of malignant biliary strictures

目的 :通过与ERCP/PTC对比 ,评价MRCP对恶性胆道狭窄的定位、定性的准确性。材料与方法 :57例恶性胆道狭窄患者 ,采用不屏气或屏气快速自旋回波(FSE)序列扫描 ,对照ERCP或PTC检查和病理结果 ,评价MRCP对恶性胆道狭窄征象的显示能力。结果 :MRCP诊断恶性胆道狭窄的定位准确性及定性准确性分别为100 %和87 8%,经统计学检验证实与ERCP/PTC不存在显著性差异。对病变胆管截断、狭窄及管壁不规则等征象的显示率为ERCP、PTC的74 0 %。对肿瘤的显示率为77 2 %。结论 :MRCP对于恶性胆道狭窄的定位、定性准确性与ERCP、PTC相似 ,但显示病变形态较ERCP和PTC差。

Objective:To compare the findings of magnetic resonance cholangiopancreatography(MRCP) with that of ERCP or PTC in biliary strictures and evaluate the accuracy of MRCP in determing the site and causes of biliary strictures.Materials and Methods:57 patients with suspected malignant biliary strictures were examined by MRCP with Fast Spin Echo sequence with or without breath-hold technique.The results of MRCP were compared with that of ERCP or PTC and pathology.Results:The accuracy of MRCP for obstructive level was 100.0%;the specificity for the cause of obstruction was about 87.8%.There is no significant difference between MRCP,ERCP or PTC.In demonstrating the signs such as biliary truncation and stricture and irregularity,MRCP can display 74.0% of the latter.MRCP can display 77.2% tumors all in all.Conclusion:The accuracy of MRCP in determing the site and causes of malignant biliary strictures is similar to that of ERCP and PTC,but its specificity to display the shape of biliary stricture is not good as the latter.