磁共振胰胆管成像对恶性胆道梗阻的诊断价值

The value of MR cholangiopancreatography in diagnosis of malignant biliary obstructions

目的 :评价磁共振胰胆管成像 (MRCP)对恶性胆道梗阻性疾病的临床诊断价值 ,探讨肝外恶性胆道梗阻的MR CP、MRI诊断及鉴别诊断。方法 :回顾性分析 6 9例恶性胆道梗阻患者的MRI及MRCP表现 ,并与CT、US、直接胆道造影和手术病理结果对照。MRCP采用二维 (2D)和 /或三维 (3D)屏气半傅立叶转换快速自旋回波 (FASE)序列T2 加权成像技术。结果 :6 9例MRCP检查均一次成功 ,全部病例胰胆管显示满意 ,与直接胆道造影对照 ,二者所获图像极其相似。MRCP对恶性胆道梗阻定位诊断准确率为 98.5 %定性诊断准确率为 95 .6 %。结论 :MRCP对恶性胆道梗阻定位及定性诊断优于CT和US 。

Objective:To evaluate the clinical value of MR cholangiopancreatography (MRCP) in diagnosis of malignant biliary obstruction, and their value in diagnosis and differential diagnosis of MRCP and MRI.Methods:69 patients with clinical signs of malignant biliary obstruction underwent MRI and MRCP and to correlate the MR findings with CT, US, direct cholangiography, surgery and pathology. MRCP was performed by using two dimensional (2D) and/or three dimensional (3D) breath hold half Fourier fast advanced spin echo (FASE) sequences with heavily T 2 weighted technique.Results:MRCP examination succeeded in all 69 patients and the pancreaticobiliary duct was shown satisfactorily in all cases. The images of MRCP were essentially identical to those of direct cholangiography. More valuable information could be obtained by MRCP in patients with inadequate direct cholangiography. The accuracy of MRCP in evaluating the site of obstruction was 98.5%.The accuracy of MRCP in evaluating the cause of obstruction was 95.6%.Conclusion:The diagnostic accuracy of MRCP in evaluating the site and nature of biliary obstruction is superior to that of CT and US. MRCP is an effective and non invasive technique in diagnosing malignant biliary obstructions.