MRI结合MRCP对肝门部胆管狭窄病因的评价

Evaluation of MRI Combined with MRCP in the Etiology of Hilar Bile Duct Stricture

目的:探讨MRI结合MRCP对肝门部胆管狭窄病因的诊断价值。材料和方法:回顾性分析66例肝门部胆管狭窄患者的临床、MRI资料,所有病例均进行MR平扫、增强及MRCP检查,其中12例经ERCP证实、6例经PTC证实,48例经手术病理证实。结果:66例肝门部胆管狭窄患者中,26例损伤性狭窄,9例肝门部胆管癌,6例肝门部转移性肿瘤,14例炎性狭窄,4例胆管结石,Mirizzi综合征及硬化性胆管炎各2例,3例先天性胆管囊肿。胆管受累范围按Bismuth分级,MRI和MRCP均显示了胆管狭窄情况及病变特征。结论:MRI和MRCP对肝门部胆管狭窄病因的诊断具有重要价值,对指导临床采取正确的治疗措施具有重要意义。

Purpose: To investigate the value of the source MRI combined with MRCP in diagnosing the etiology of hilar bile duct stricture. Materials and Methods: The MRI and MRCP features of 66 patients with hilar bile duct stricture were reviewed retrospectively, all patients received MRI pre - and post - contrast scan and MRCP examination, of 12 cases were proved by ERCP, 6 cases were proved by PTC, and 48 cases were proved by surgery and pathology. Results: Among the 66 patients, 26 patients suffered from injurious strictures, hilar bile duct carcinomas were found in 9 patients, 6 patients were hilar metastatic tumors , 14 patients were inflammatory strictures, 4 patients were bile duct stones, 2 patients were Mirizzi syndromes, 2 patients were sclerosing cholangitis, 3 patients were congenital biliary duct cysts. The lesion range of bile duct was classified according to Bismuth standard,all the strictures and lesion features were displayed on MRI and MRCP images.Conclusion: MRI and MRCP are important in diagnosing the strictures of the hilar bile duct, and are valuable for guiding clinical therapy.