肝外胆管恶性梗阻性病变的磁共振胰胆管造影诊断

MR cholangiopancreatography for the diagnosis of malignant extrahepatic bile duct obstructive diseases

目的 探讨磁共振胰胆管造影 (MRCP)对肝外胆管恶性梗阻性疾病的诊断价值。方法 结合MRI或CT检查 ,对 83例MRCP诊断为肝外胆管恶性梗阻性病变资料 ,对照手术及病理结果进行分析。所有病例的MRCP检查 ,均采用单次激发快速采集弛豫增强 (RARE)和多层面半付里叶采集单次激发快速自旋回波 (HASTE)两种序列扫描。结果 83例MRCP均一次性检查成功 ,获得有价值的诊断图像。其定位诊断准确率为 10 0 %、定性诊断准确率为 96 4 %。结论 临床上疑患胆管恶性梗阻性病人 ,结合MRI或CT扫描 ,MRCP可作为其主要检查手段 ,据此可直接行手术治疗。

Objective To evaluate the value of MR cholangiopancreatography(MRCP) in diagnosis of extrahepatic biliary obstructive diseases.Methods MRCP with MRI or CT were performed in 83 patients with malignant extrahepatic biliary obstructive diseases.The results of MRCP were compared with surgical findings and pathology.All the cases were examined using both the single shot rapid acquisition with relaxation enhancement(RARE) and the multislice half fourier acquisition single shot turbo spin echo(HASTE).Results MRCP was obtained in all 83 patients at a time and the images were available for diagnosis.The accuracy of MRCP in detection of the degree and level of extrahepatic biliary obstruction was 100%,and the accuracy for assessment of obstructive causes was 96.4%.Conclusion By the help of MRI or CT,MRCP can be used as a main clinical procedure in detection of patients with suspected of malignant biliary obstructive diseases.The operation can be performed according to the result of MRCP.Only a small quantity of patients needs ERCP or PTC examination.