MR动态增强结合MRCP对64例壶腹周围癌的诊断及鉴别分析

Analysis of Diagnosis and Differential Diagnosis of Dynamic Contrast-enhanced MRI combined with MRCP for 64 Cases of Periampullary Adenocarcinomaes

目的:探讨MR动态增强结合磁共振胰胆管成像(MRCP)对壶腹周围癌的诊断及鉴别诊断价值。方法:回顾性分析64例经病理学证实壶腹周围癌的MRI资料,并复习相关文献。结果:64例中胰头癌35例,胆总管下段腺癌11例,壶腹癌8例,十二指肠腺癌10例。58例表现为壶腹区域大小不等的软组织信号结节或肿块,3例胆总管下段癌及3例十二指肠腺癌表现局部管壁增厚,61例伴有程度不等的低位胆管和/或胰管梗阻。不同类别肿瘤的MR表现既有共同之处,又各有特点。结论:MR动态增强结合MRCP对壶腹周围癌的诊断及鉴别具有较大价值。

Objective To investigate the diagnostic and differentional value of dynamic contrastenhanced MRI combined with MRCP for periampullary adenocarcinoma.Methods The MRI of 64 cases of periampullary adenocarcinomaes confirmed by pathology were retrospectively analyzed and relevant literature was reviewed.Results Among 64 cases,35 cases were pancreatic head adenocarcinomaes,11 cases were lower common bile duct adenocarcinomaes,8 cases were ampullary adenocarcinomaes and 10 cases were duodenal adenocarcinomaes.58 cases showed that nodules or masses with density of soft tissue and different sizes around ampulla.3 cases adenocarcinomaes of lower common bile duct and 3 cases of duodenal adenocarcinomaes showed local thickening of tube wall.61 cases were accompanied with obstruction of common bile duct and/or the main pancreatic duct with different degree.The imaging manifestations of different types of tumors showed both similarities and characteristics.Conclusion Dynamic contrast-enhanced MRI combined with MRCP is of important value in the diagnosis and differential diagnosis of periampullary adenocarcinoma.