MRCP和MRI在胰胆管梗阻诊断中的应用

Application of Pancreatic Duct and Biliary Tract's Obstruction by MRCP and MRI

目的 探讨磁共振胰胆管造影(MRCP)对胰胆管梗阻的诊断价值。方法 采用Marconi eclipse 1.5T超导磁共振设备,MRCP应用express序列,分析经临床或病理证实的41例患者的MRCP、MBI及MRI增强的影像。结果 胰胆管梗阻定位诊断准确率达100％,定性诊断准确率分别为:MRCP+MBI平扫85.6％,MRCP+MRI平扫+增强92.7％;单纯MRCP病因诊断准确率分别为:胆道结石90％(9/10);医源性梗阻60％(3/5);胆管癌66.6％(6/9);胰头癌83.3％(10/12);壶腹癌60％(3/5)。结论 MRCP结合MR平扫和增强扫描,对胰胆管梗阻病变诊断准确率更高。

Objective To investigate the diagnosis value of the pancreatic duct and biliary tract's obstruction. Methods 41 cases which were confirmed by clinical and pathologic data were evaluated by MRCP, MRI and post-contrast MRI. All the cases were performed in Marconi eclipse 1.5 Tsuperconductive MR scaner,and MRCP were performed by using express sequence. Results The accuracy of localizative diagnosis of the pancreatic duct and biliary tract's obstruction was 100% , and the accuracy of qualitative diagnosis was: MRCP + pre-contrast MRI(85. 6% ) ,MRCP + pre-contrast and post-contrast MRI(92.7% ) respectively; the accuracy of etiologic diagnosis only by using MRCP was:9 cases were diagnosed correctly in 10 cases of the biliary calculi;3 cases were diagnosed correctly in 5 cases of the iatrogenic obstruction; 6 cases were diagnosed correctly in 9 cases of cholangiocarcinoma; 10 cases were diagnosed correctly in 5 cases of ampullacarcinoma. Conclusion MRCP was similar as ERCP imaging, and it was safe and convient and localized the leisions accurately. MRCP had extensive prospect of usage. If combined with pre-and post-contrast MR study, the accuracy of the diagnosis will be more accurate.