非ERCP适应证的恶性胆管梗阻病人MRCP诊断价值

Diagnostic value of MRCP for malignant obstruction of bile duct with non-ERCP indications

目的 探讨磁共振胰胆管成像 (MRCP)对非ERCP适应证的恶性胆管梗阻病人的诊断价值。方法 对 2 5例内窥镜逆行胰胆管造影 (ERCP)不成功或不适宜而临床怀疑为恶性梗阻性黄疸的老年病人进行MRCP检查。结果 11例ERCP不成功和 14例因病人一般状况不宜做ERCP的老年病人均获得了具有诊断价值的MRCP图像。MRCP准确地显示了手术病理证实为恶性肿瘤的 2 5例病人的梗阻部位 (2 5 /2 5 ,10 0 %)。MRCP对梗阻性质诊断的准确率为 96%(2 4/2 5 )。结论 MRCP能够清楚地显示肝内或肝外胆管的梗阻 ,并能对梗阻的性质和病变的范围作出理想的判断 ,是目前非ERCP适应证的恶性胆管梗阻病人最理想的非创伤性检查方法 ,能够有效地帮助临床做出合适的手术方案。

Objective To evaluate the diagnostic value of MRCP (magnetic resonance cholangiopancreatography) for malignant obstruction of bile duct patients with non-ERCP (endoscopic retrograde cholangiopancreatography) indications. Methods Twenty-five senile patients for whom the ERCP were unsuccessful or unsuitable suspected as malignant obstruction of bile duct,were performed MRCP examination.Results The MRCP imagings were obtained in all of 25 patients with non-ERCP indications,including 11 unsuccessful ERCP and 14 contraindication to ERCP. MRCP accurately showed the obstructive position of 25 patients confirmed by surgery and pathology (25/25,100%). The accuracy for diagnosis of malignant obstruction was 96% (24/25). Conclusion MRCP is the optimal noninvasive method for malignant obstruction of bile duct patients with non-ERCP indications,and MRCP can also provides useful information for surgical planning.