磁共振Fiesta序列结合MRCP对Mirizzi综合征的诊断价值

Diagnostic value of magnetic resonance fiesta sequence combined with MRCP for mirizzi syndrome

目的：探讨磁共振Fiesta序列联合MRCP对Mirizzi综合征的诊断价值。方法回顾性分析2010年6月~2014年4月在我院行术前MR检查并经手术病理证实的Mirizzi综合征18例，对Mirizzi综合征在Fiesta、MRCP上的各种征象进行分析并与手术结果进行对照，比较Fiesta联合MRCP与单独用Fiesta及MRCP检查对Mirizzi综合征的诊断准确率。结果18例Mirizzi综合征中，Ⅰ型15例，Ⅱ型3例。18例均可见胆囊颈部或胆囊管结石，肝总管受压16例，Calot三角结构不清11例。 Fiesta联合MRCP对于Mirizzi综合征诊断的准确率明显高于单独使用Fiesta及MRCP，二者有显著性差异（P〈0.05），与手术有高度的一致性。结论 Fiesta联合MRCP对于Mirizzi综合征的术前诊断具有较高价值。

Objective To explore the diagnostic value of magnetic resonance Fiesta sequence combined with MRCP for Mirizzi syndrome. Methods Retrospective analysis was carried out for 18 patients who received MR examination before surgery in our hospital from June 2010 to April 2014 and were diagnosed as Mirizzi syndrome by surgical pathology. Various signs of Mirizzi in Fiesta and MRCP were analyzed and compared with surgical results. Diagnostic accuracy was compared between the combined use of Fiesta and MRCP and the use of Fiesta or MRCP alone. Results Among 18 patients with Mirizzi, 15 were type Ⅰ and 3 were type II. Calculi in gallbladder neck or cystic duct could be seen in all the 18 patients, common bile duct under pressure could be seen in 16 patients and unclear Calot triangle structure could be seen in 11 patients. Accuracy of Fiesta combined with MRCP for the diagnosis of Mirizzi syndrome was sig-nificantly higher than that of Fiesta or MRCP alone, and the differences were statistically significant （P〈0.05）. It was highly consistent with the surgical results. Conclusion Fiesta combined with MRCP has relatively high value for pre-operative diagnosis of Mirizzi syndrome.