胆道术后损伤及其并发症的MRI表现特点

MRI characteristics of bile duct injury and postoperative complications

目的探讨MRI胰胆管成像(MRCP)结合常规MRI扫描对胆道损伤的诊断价值。方法回顾性分析58例胆道损伤的MRI特点。结果 19例胆道损伤:肝管及胆总管误扎5例MRCP显示截断征,8例胆漏MRI表现为胆囊窝及其附近局限性长T1WI、长T2WI信号。3例肝包膜下积液,3例胆总管下段炎性狭窄,MRCP示胆总管渐渐性狭窄。8例残余胆囊并有结石6例,MRCP示胆囊窝处见残余胆囊管末端囊性扩张高信号,内有低信号影。结论 MRCP加MR常规扫描对胆道损伤及其并发症的诊断具有重要价值。

Objective To investigate the value of conventional T1 -and T2-weighted images and MR cholangiopancreatogrphy （MRCP） in diagnosis of bile duct injury. Methods The MR characteristics of 58 patients with bile duct injury and its complica- tions were retrospectively analyzed. Results In those 19 cases of bile duct injury, MRCP showed truncated sign in 5 cases with mistaken ligation of hepatic duct and common bile duct and MR showed the limited TIWI and long T2WI signal near gallbladder fossa in 8 cases of bile leakage. 3 cases appeared fluid under envelop of live. 3 cases appeared inflammatory stenosis in the lower segment of common bile duct. MRCP showed gradual stenosis of common bile duct. In 8 cases with residual gallbladder, 6 cases had gallbladder stone. MRCP showed the cystic expansion high signal at the end of residual gallbladder tube in gallbladder fossa, with low signal inside it. Conclusion The usage of nonenhanced T1-and T2-weighted images and MRCP could significantly im- prove the diagnostic accuracy of MR examinations in bile duct injury