磁共振胆胰管造影联用动态增强在十二指肠乳头肿大评价的应用

Magnetic resonance cholangiopancreatography combined with dynamic enhancement in application of duodenal breast enlargement evaluation

目的:评价磁共振胆胰管造影联用动态增强在十二指肠乳头肿大评价的应用价值。方法:回顾性分析80例经肠镜证实十二指肠乳头肿大的患者,对比分析不同病因所致十二指肠乳头肿大的影像学表现,并评价磁共振胆胰管造影联用动态增强在诊断十二指肠乳头肿大中的价值。结果:所有病例均顺利完成MRI及肠镜检查。80例十二指肠乳头肿大中,肠镜证实十二指肠乳头癌21例,胆总管下段癌2例,十二指肠管状腺瘤6例,十二指肠乳头慢性炎症28例,胰腺癌11例,胆总管囊肿6例,神经内分泌瘤4例,胰腺实性假乳头状瘤1例,异位胰腺1例;引起十二指肠乳头肿大的良性病变共40例,其MRI表现为:直径多小于15mm(38/40,95.0%),类圆形(34/40,85.0%),强化均匀(37/40,82.5%),多伴有胆管结石(29/40,72.5%),胆总管下段最大径多小于13.0mm(37/40,82.5%);恶性病变十二指肠乳头多发大于15mm(33/40,82.5%),形态不规则(37/40,82.5%),强化不均匀(37/40,82.5%),不伴有胆管结石(39/40,97.5%),胆总管下段最大径大于13.0mm(40/40,100.0%)。磁共振胆胰管造影联用动态增强能清晰的显示十二指肠乳头,对十二指肠乳头肿大恶性病变的诊断准确率95.0%。结论:磁共振胆胰管造影联用动态增强能为临床提供十二指肠乳头及其周围临近结构病变非常重要的影像学信息。

Objective To evaluate the application value of magnetic resonance cholangiopancreatography combined Methods 80 cases of duodenal papillary enlargement confirmed by colonoscopy were retrospectively analyzed,and the imaging manifestations of duodenal papillary enlargement caused by different causes were compared.Results MRI and colonoscopy were successfully completed in all cases.Of 80 cases of duodenal papilla enlargement,colonoscopy confirmed 21 cases of duodenal papilla carcinoma,under the common bile duct carcinoma in 2 cases,duodenal tubular adenoma.Conclusion Magnetic resonance cholangiopancreatography combined with dynamic enhancement can provide very important imaging information of duodenal papilla and its adjacent structural lesions.