磁共振成像在胰胆管疾病中的应用

Application of MRI in Pancreaticobiliary Tract Diseases

目的：介绍用磁共振检查胰胆管疾病的四种扫描序列，并评价它们的作用和局限性。材料和方法：对５２例疑有胰胆管疾病的患者行两种Ｔ２加权和两种ＭＲＣＰ序列检查；横断位ＨＡＳＴＥ序列、冠状位ＴｒｕｅＦＩＳＰ序列、ＴｕｒｂｏＳＥＭＲＣＰ序列和ＨＡＳＴＥＭＲＣＰ序列。４２例经ＥＲＣＰ或手术病理证实，其检查结果与ＥＲＣＰ或手术对照。结果：所有图像的质量均达到了能够诊断的要求。四种扫描序列均显示了所有扩张的胰胆管，胆管结石定性的准确性分别为８７．５％、９１．７％、８７．５％和９５．８％，对肿瘤的定性准确性分别为８２．４％、７６．５％、６４．７％和７０．６％，结合所有序列对结石定性的准确性为１００％，对肿瘤的定性准确性为８８．２％。结论：上述四种扫描序列对显示胆胰管疾病各有其优点，结合应用可提高胰胆管疾病检出率和作出更准确的定性诊断。

Purpose: To evaluate the role and the limit of four MRI sequences for detection of pancreaticobiliary tract diseases. Materials and Methods: Breath - hold HASTE, True FISP, Turbo SE MRCP and HASTE MRCP sequences were performed in 52 patients with suspected pancreaticobiliary disease. Imaging findings on these sequences were compared with direct endoscopic retrograde cholangiopancreatography, surgical and/or pathologic findings (42 patients). Results: Images of diagnostic quality were obtained in all cases. All sequences showed 100% sensitivities in recognizing the dilated pancreaticobiliary tract. In 42 proved Patients, the diagnostic accurate rates for HASTE, True FISP, Turbo SE MRCP, and HASTE MRCP in the diagnosis of pancreaticobiliary stone were 87. 5% ,91. 7% , 87. 5% 3 and 95. 8% , respectively; And in the diagnosis of tumor were 82. 4%, 76. 5% , 64. 7% ) and 70. 6%, respectively. When all imaging sequences were combined, the accurate rates for calculi and tumor detection were 100% and 88. 2%, respectively. Conclusion: The four MRI sequences have their own merit in recognizing pancresticobiliary tract diseases. More accurate diagnosis can be obtained, if these imaging sequences are applied together.