Magnetic resonance cholangiopancreatography study of pancreaticobiliary maljunction and pancreaticobiliary diseases

AIM:To discuss the imaging anatomy about pancreaticobiliary ductal union,occurrence rate of pancreaticobiliary maljunction(PBM)and associated diseases in a Chinese population by using magnetic resonance cholangiopancreatography(MRCP).METHODS:Data were collected from 694 patients who underwent MRCP from January 2010 to December2012.Three hundred and ninety-three patients were male and 301 patients were female.The age range was16-92 years old and the average age was 51.8 years.The recruitment indication of all cases was patients who had clinical symptoms,such as abdominal pain,jaundice,nausea and vomiting,which thus were clinically suspected as relative pancreaticobiliary diseases.All cases were examined by MRCP using single-shot fast spin-echo sequences.In order to obtain MRCP images,the maximum intensity projection was used.RESULTS:According to the anatomy of pancreaticobiliary ductal union based on our analysis of MRCP images,all cases were classified into normal type and abnormal type according to the position of pancreaticobiliary ductal union.The abnormal type could be further divided into P-B type,B-P type and the duodenum type.By analyzing the incidence of biliary stone and inflammation,pancreatitis,biliary duct tumors and pancreatic tumors between normal and abnormal types,significant differences existed.The abnormal group was more likely to suffer from pancreaticobiliary diseases.Comparing three different types of PBM that were associated with pancreaticobiliary diseases by using Fisher’s method,the result showed that there was no significant difference in the incidence of biliary stones,cholecystitis and pancreatic tumors.The incidence of pancreatitis in B-P type and P-B type was higher than that in duodenum type;the incidence of biliary duct tumor in B-P type was higher than that in P-B type;the incidence of biliary duct tumor in duodenum type was lower than that in P-B type.The incidence of congenital choledochus dilatation in normal type and abnormal type was similar,and there was no significant difference between the two types.CONCLUSION:Types of PBM are closely related to the occurrence of pancreaticobiliary diseases.MRCP has important clinical value in the early diagnosis and preventive treatment of pancreaticobiliary diseases.

Gd-EOB-DTPA-enhanced magnetic resonance imaging for bile duct intraductal papillary mucinous neoplasms

AIM: To investigate gadolinium-ethoxybenzyldiethylenetriamine-pentaacetic acid(Gd-EOB-DTPA)-enhanced magnetic resonance imaging(MRI) of intraductal papillary mucinous neoplasms of the bile duct(IPMN-B). METHODS: The imaging findings of five cases of IPMN-B which were pathologically confirmed at our hospital between March 2012 and May 2013 were retrospectively analyzed. Three of these cases were diagnosed by duodenal endoscopy and biopsy pathology, and two cases were diagnosed by surgical pathology. All five patients underwent enhanced and non-enhanced computed tomography(CT), magnetic resonance cholangiopancreatography, and Gd-EOB-DTPA-enhanced MRI; one case underwent both Gd-EOB-DTPA-enhanced MRI and positron emission tomography-CT. The clinical data and imaging results for these cases were compared and are presented.RESULTS: Conventional imaging showed diffusedilatation of bile ducts and multiple intraductal polypoid and papillary neoplasms or serrated changes along the bile ducts. In two cases, Gd-EOB-DTPA-enhanced MRI revealed dilated biliary ducts and intraductal tumors, as well as filling defects caused by mucin in the dilated bile ducts in the hepatobiliary phase. GdEOB-DTPA-enhanced MRI in one case clearly showed a low-signal tumor in the hepatobiliary phase, similar to what was seen by positron emission tomographyCT. In two patients, routine inspection was unable to discern whether the lesions were inflammation or tumors. However, Gd-EOB-DTPA-enhanced MRI revealed a pattern of gradual enhancement during the hepatobiliary phase, and the signal intensity of the lesions was lower than the surrounding liver parenchyma, suggesting tissue inflammation in both cases, which were confirmed by surgical pathology. CONCLUSION: Gd-EOB-DTPA-enhanced MRI reveals the intraductal mucin component of IPMN-B in some cases and the extent of tumor infiltration beyond the bile ducts in invasive cases.

Magnetic resonance cholangiopancreatography image enhancement for automatic disease detection

AIM:To sufficiently improve magnetic resonance cholangiopancreatography(MRCP) quality to enable reliable computer-aided diagnosis(CAD).METHODS:A set of image enhancement strategies that included filters(i.e.Gaussian,median,Wiener and Perona-Malik),wavelets(i.e.contourlet,ridgelet and a non-orthogonal noise compensation implementation),graph-cut approaches using lazy-snapping and Phase Unwrapping MAxflow,and binary thresholding using a fixed threshold and dynamic thresholding via histogram analysis were implemented to overcome the adverse characteristics of MRCP images such as acquisition noise,artifacts,partial volume effect and large inter-and intra-patient image intensity variations,all of which pose problems in application development.Subjective evaluation of several popular pre-processing techniques was undertaken to improve the quality of the 2D MRCP images and enhance the detection of the significant biliary structures within them,with the purpose of biliary disease detection.RESULTS:The results varied as expected since each algorithm capitalized on different characteristics of the images.For denoising,the Perona-Malik and contourlet approaches were found to be the most suitable.In terms of extraction of the significant biliary structures and removal of background,the thresholding approaches performed well.The interactive scheme performed the best,especially by using the strengths of the graphcut algorithm enhanced by user-friendly lazy-snapping for foreground and background marker selection.CONCLUSION:Tests show promising results for some techniques,but not others,as viable image enhancement modules for automatic CAD systems for biliary and liver diseases.

Magnetic resonance cholangiography in the assessment and management of biliary complications after OLT

Despite advances in patient and graft management,biliary complications(BC)still represent a challenge both in the early and delayed period after orthotopic liver transplantation(OLT).Because of unspecific clinical presentation,imaging is often mandatory in order to diagnose BC.Among imaging modalities,magnetic resonance cholangiography(MRC)has gained widespread acceptance as a tool to represent the reconstructed biliary tree noninvasively,using both the conventional technique(based on heavily T2-weighted sequences)and contrast-enhanced MRC(based on the acquisition of T1-weighted sequences after the administration of hepatobiliary contrast agents).On this basis,MRC is generally indicated to:(1)avoid unnecessary procedures of direct cholangiography in patients with a negative examination and/or identify alternative complications;and(2)provide a road map for interventional procedures or surgery.As illustrated in the review,MRC is accurate in the diagnosis of different types of biliarycomplications,including anastomotic strictures,nonanastomotic strictures,leakage and stones.

3D BH-GRASE序列与3D RT-TSE序列进行MRCP的应用价值分析

目的探讨对比分析三维屏气梯度-自旋回波(3D BH-GRASE序列)与三维呼吸触发快速自旋回波(3D RTTSE)序列进行磁共振胰胆管成像(MRCP)的应用价值。方法选取在我院因怀疑胰胆管病变而行腹部MRI检查的患者,均接受3D RT-TSE序列与3D BH-GRASE序列MRCP扫描。比较两种序列扫描时间、图像质量评分及显示病变情况。结果3D BH-GRASE序列的扫描时间为(16.4±1.7)s明显短于3D RT-TSE序列的(258.6±31.2)s,差异有统计学意义(P<0.05);3D BH-GRASE序列扫描图像胆囊、肝内胆管、胆囊管、胰管、胆总管等主要分支评分均明显高于3D RTTSE序列,差异有统计学意义(P<0.05);两种扫描序列方法对各区域病变检出率差异无统计学意义(P>0.05)。结论MRCP检查应用3D BH-GRASE序列扫描能够保证图像质量及显示病变,同时缩短扫描时间。

基于术前磁共振成像分类指导精囊镜技术治疗精道远端疾病的临床研究

目的探讨术前磁共振成像(MRI)分类指导精囊镜技术治疗精道远端疾病的可行性和安全性。方法回顾性分析2019年1月至2023年2月在合肥市第二人民医院接受精囊镜技术治疗的35例精道远端疾病患者的临床资料。所有患者术前均接受了精道远端的MRI检查,根据MRI影像学结果分为梗阻型精道远端疾病与非梗阻精道远端疾病两种类型。所有患者在硬膜外麻醉或全麻下接受F6/7.5精囊镜检查,分析并对比两种类型患者精囊镜手术的进镜成功率、进镜方式、手术时间、术后并发症等。结果35例精囊镜手术精囊镜均成功进入精囊。17例MRI诊断为梗阻型精道远端疾病的患者中,有88.2%(15/17)的患者术中需经小囊途径进入精囊,平均手术时间为(96.8±58.7)min;18例MRI诊断为非梗阻型精道远端疾病的患者中,有44.4%(8/18)的患者需经小囊途径进入精囊,平均手术时间为(96.9±59.2)min。两类患者进镜方式比较,差异具有统计学意义(P<0.05);但手术时间比较,差异无统计学意义(P>0.05)。经术后随访,所有患者均未出现附睾炎、逆行射精、直肠损伤等严重并发症。结论术前通过MRI影像对精道远端疾病患者进行分类可以有效指导精囊镜手术方式的选择,提高手术进镜的成功率,提高手术的安全性。

CLINICAL APPLICATION OF MR CHOLANGIOPANCREATOGRAPHY

Objective To evaluate the cllnical value of MR cholangiopancreatography (MR CP) in diagnosis of pancreaticobiliary duct disease. Methods MRCP was performed in fihy- eight cases, including sixteen persons as comparison and forty - two patients with various pancreaticobiliary duct diseases. MRCP uses non - breath - hold Turbo Spin - Echo (TSE) sequence with respiratory - triggering and fat - suppression techniques. Three - dimensional (3D) reconstruction was used for postProcedure processing with a maximum - intensity -projection (MIP) algorithm. ResuIts MRCP examination was succeeded in all 58 cases. In 16persons as comparison, gallbladder, extrahepatic bile duct and partial intrahePatic bile duct or main pancreatic duct were visualized clearly. In 42 patients with pancreaticobiliary duct disease, MRCP can exhibit the imaging characteristic of various pancreaticobiliary duct diseases and the total diagnostic accuracy was 85.7%. The accuracy of MRCP in the detection of the degree and location of bile duct obstruction was 100%. The accuracyof MRCP for evaluating the causes ol obstruction was 83.8%. In the diagnosis of choledocholithiasis and malignant bile duct obstruction, the diagnostic accuracy of MRCP was 90.9% and 80.0%, respectively. ConcIusion MRCP examination has a high success rate and can depict pancreaticobiliary duct clearl,. Because of reliable value in diagnosing pancreaticobiliary duct diseases, MRCP may provide an efjcient alternative to direct cholangiopancreatography, especially when the diagnostic ERCP and percutaneous transhepatic cholangiography (PTC) are unsuccessful or inadequate.

Neuroendocrine Tumor Arising from Common Bile Duct: A Case Report and Literature Review

Neuroendocrine tumor (NET) arising from common bile duct (CBD) is a rare disease entity, whose origin is currently in discussion with various theories. We present a case of well-defined solid, exophytic and arterial hypervascular mass arising from CBD with relatively mild dilated central intrahepatic bile ducts in 50-year-old man, which was surgically confirmed to be extrahepatic biliary NET, and reviewed radiologic features of extrahepatic biliary NET in previous literature.

压缩感知磁共振胰胆管成像对胆总管良恶性梗阻的诊断价值

目的探讨屏气压缩感知磁共振胰胆管成像(breath-hold magnetic resonance cholangiopancreatography with compressed sensing,BH-CS-MRCP)鉴别诊断胆总管良恶性梗阻的价值。材料与方法招募临床确诊的胆总管梗阻患者,所有患者均行BH-CS-MRCP、呼吸导航的压缩感知磁共振胰胆管成像(navigator-triggered magnetic resonance cholangiopancreatography with compressed sensing,NT-CS-MRCP)和常规磁共振胰胆管成像(traditional magnetic resonance cholangiopancreatography,T-MRCP)序列扫描,并记录扫描时间。由两位影像诊断医师对三组MRCP的图像质量、胆管及胰管的显示度、梗阻病变的可视度和锐度、梗阻病变的良恶性判断进行评估。采取单因素方差分析比较三种序列图像评价指标的差异,分别计算其敏感度、特异度、准确度。结果68例胆总管梗阻患者,年龄(59.97±15.75)岁,男42例,女26例,良性梗阻49例,恶性梗阻19例。BH-CS-MRCP、NT-CS-MRCP、T-MRCP扫描时间分别为17 s、(210.61±38.52)s、(443.65±78.45)s。BH-CS-MRCP、NT-CS-MRCP、T-MRCP对图像总体质量、胆管(胆总管、一级胆管、二级胆管)、胰管的显示差异无统计学意义(P>0.05)。三种序列对梗阻部位病变的锐度及可视度的评分差异无统计学意义(P>0.05)。胆总管恶性梗阻诊断中,BH-CS-MRCP、NT-CS-MRCP的敏感度均为84.21%、特异度均为91.84%、准确度均为89.71%,T-MRCP的敏感度为84.21%、特异度为89.58%、准确度为86.76%。结论和T-MRCP相比,BH-CS-MRCP和NT-CS-MRCP可以利用较短的时间获得相当质量的图像及较好的胆总管良恶性梗阻的鉴别诊断效能。

磁共振胰胆管成像的临床应用研究

目的：评价磁共振胰胆管成像（ＭＲＣＰ）的临床应用价值。材料与方法：在ＰｈｉｌｉｐｓＧｙｒｏｓｃａｎＴ１０ＮＴ１．０Ｔ超导型磁共振成像仪上进行ＭＲＣＰ检查５８例，其中作为正常对照组１６例，各种胰胆管病变者４２例。ＭＲＣＰ采用不屏气涡轮自旋回波（ＴＳＥ）序列的重度Ｔ２加权像扫描（ＴＲ／ＴＥ＝２０００ｍｓ／７００ｍｓ），并应用呼吸触发及脂肪抑制技术。图像后处理以最大强度投影法（ＭＩＰ）进行三维（３Ｄ）重建。结果：５８例ＭＲＣＰ检查均一次成功，５７例胰胆管显示满意，其效果类似于直接胰胆管造影图像。１６例正常对照者，胆囊、肝外胆管及部分肝内胆管和主胰管的解剖形态显示清晰。４２例胰胆管病变者，ＭＲＣＰ可显示各种病变的影像学特征，总的诊断符合率为８５．７％（３６／４２），对胆道梗阻程度的判断和定位诊断准确性为１００％（３７／３７），定性诊断准确性为８３．８％（３１／３７）。ＭＲＣＰ诊断胆总管结石和恶性胆道梗阻的准确性分别为９０．９％（１０／１１）和８０．０％（１２／１５）。结论：研究表明，ＭＲＣＰ检查成功率高，胰胆管显示清晰，对各种胰胆管病变的临床应用适应症广泛，诊断价值可靠，尤其是在直接胰胆管造影失败或检查不完全时，?

MRCP时联合应用MR平扫及增强扫描的价值

目的 评价MR平扫及动态增强扫描联合应用在MRCP诊断胰胆管疾病中的补充价值。方法 回顾分析64例胰胆管疾病病例的MRI表现,由两名有MR诊断经验的影像医生在无临床资料的情况下分为MRCP、MRCP与MR平扫结合、MRCP结合MR平扫及动态增强三步阅片,与手术、病理结果或临床综合诊断对照后进行对比分析。结果 第一、二步骤间定性诊断准确率、敏感度及特异度分别提高17.2%、14.7%及20%,差异显著(χ2=6.02,P<0.05),而第二、三步骤间差异不显著(χ2=1.74,P>0.05),但诊断准确率及确认度三步骤间均有显著差异。结论 MRCP应与MR平扫及动态增强扫描相结合,MR平扫与MRI动态增强扫描必要且有价值。

磁共振胰胆管成像在诊断胰胆管疾病中的价值

目的 :评价磁共振胰胆管成像 (MRCP)诊断阻塞性和扩张性胰胆管疾病的临床价值。方法 :采用西门子symphony 1.5T超导磁共振成像仪 ,对 72例胰胆管系统疾病患者和 2 0例正常对照组进行MRI和MRCP成像 ,其中病变组 2 2例进行Gd DTPA动态增强。分析图像 ,将诊断结果与手术病理和超声、CT等其它影像检查结果对照。结果 :MRCP能清晰显示正常胰胆管树的结构 ,能直观显示胰胆管扩张和梗阻的部位、形态、范围。检出率和定位率为 94.3 % ,定性率为 85 .7%。MRI图像能帮助定性诊断。结论 :MRCP是一种安全、有效的胰胆管系统影像检查方法 ,与MRI结合 。

非屏气MRCP对于胆道梗阻性疾病的诊断价值(附60例ERCP与MRCP比较)

目的：研究非屏气ＭＲＣＰ技术显示胆道病变的能力。方法：６０例胆道梗阻性疾病患者进行了前瞻性ＭＲＣＰ和ＥＲＣＰ检查。分析ＭＲＣＰ图像胆胰管显示情况，有无充盈缺损及梗阻，作出定性诊断，并与ＥＲＣＰ比较。结果：ＭＲＣＰ和ＥＲＣＰ分别显示了１００％和８８％的胆管结石。对肿瘤及其它胆道梗阻病变，ＭＲＣＰ显示病变部位和形态的作用与ＥＲＣＰ基本一致。总的定性诊断准确性ＭＲＣＰ为８５％，ＥＲＣＰ为８８％。结论：非屏气ＭＲＣＰ是诊断胆道梗阻性疾病的可靠方法。

磁共振胰胆管成像在胰胆管疾病中的诊断价值

目的：探讨磁共振胰胆管成像（ＭＲ ｃｈｏｌａｎｇｉｏｇｒａｐｈｙ，ＭＲＣＰ）对胰胆管疾病的诊断价值。材料和方法：用 ｆａｓｔ－ＡＳＥ序列完成了８２例ＭＲＣＰ检查，其中有６３例经手术病理证实，余为超声或ＣＴ证实。经二维（２Ｄ）及三维（３Ｄ）处理图像，后以最大信号投影重建图像。结果：全部检查均获得成功。良、恶性胰胆管疾病的在ＭＲＣＰ图像上具有一定的特征性。ＭＲＣＰ定位及定性准确率分别为１００％及８６％。结论：ＭＲＣＰ是一种无创伤性的有效手段，能清楚显示正常或异常的胰胆管结构，定性和定位准确率高，能为临床提供十分有意义的诊断资料。

磁共振胰胆管成像与经内镜逆行胰胆管造影对胆道梗阻性疾病诊断价值的比较

目的比较磁共振胰胆管成像(MRCP)和经内镜逆行胰胆管造影(ERCP)对胆胰疾病的诊断价值。方法对47例胆胰疾病患者行MRCP和ERCP检查,并进行对照分析。结果 MRCP和ERCP总的诊断准确率分别为85.1%和93.6%,对胆胰恶性疾病的诊断准确率分别为82.1%和89.2%,对胆总管结石的诊断准确率分别为89.5%和100%。结论 MRCP是一种安全无创检查手段,可作为胆道梗阻性疾病的首选检查方法,但不能取代ERCP,两者结合互补,可提高胆道梗阻性疾病的诊断准确率。

磁共振胰胆管成像诊断胰胆管合流异常的价值

目的 探讨磁共振胰胆管成像（MRCP）诊断胰胆管合流异常（APBDU）的价值。资料与方法 分析11例患者的MRCP、轴面T2WI及T1WI。测量共通管长度和胆总管宽度，观察APBDU的形式，以及胆管内有无结石和肿瘤等相关疾病。将观察结果与B超及内镜逆行性胰胆管造影（ERCP）检查和／或外科手术所见对照。结果 10例胆总管囊肿型APBDU包括胆管囊状扩张7例，梭形扩张3例；1例非囊肿型APBDU表现为胆总管轻度扩张。胆总管最大直径范围是12～90mm，平均34mm。APBDU的合流形式包括A型7例，B型4例，在MRCP图像测量的共通管长度范围是18～30mm，平均23mm。轴面T2WI显示胆总管或胰管突然蝌蚪或逗点样增粗5例。APBDU相关疾病包括胆囊／胆管结石6例，胆管肿瘤1例，胰腺炎5例。对7例切除的病变胆管和胆囊标本进行病理组织学检查，均有慢性炎症改变。结论 MRCP检查有助于发现和诊断APBDU，轴面T2WI和B超检查阴性结果不能完全排除本病。

磁共振胰胆管造影结合多种MRI技术在胰胆管疾病诊断中的价值

目的 探讨磁共振胰胆管造影结合多种MRI技术对胰胆管疾病诊断的价值。方法 对经手术病理或ERCP证实的胰胆管疾病患者 10 0例 ,行包括冠状位T2加权、横断位T2加权、横断位T1加权、TurboSEMRCP序列及HASTEMRCP序列的MRI检查。结果 MRCP对胰胆管疾病定性诊断准确率为 91.0 % ;结合其他MR成像序列 ,定性诊断准确率为 99.0 %(χ2 =6.73 68,P <0 .0 5 )。对胆系结石 ,TurboSEMRCP检出率为 94.9% ,HASTEMRCP原始图像结合 3D图像的检出率为 98.7% ;HASTEMRCP 3D图像检出率为 84.6% ,与TurboSEMRCP之间存在显著差异 (χ2 =4.45 72 ,P <0 .0 5 )。结论 MRCP与其他MR成像技术结合应用 ,可准确判断梗阻部位 。

胆道扩张的形态学MR表现对胆道梗阻性病变的诊断分析

目的根据胆道扩张的形态学的影像表现对不同胆道梗阻性病变进行分析,判断其原发病灶的性质。方法收集我院2014年1月~2016年3月共计95例梗阻性黄疸患者,行磁共振成像及磁共振胰胆管造影(MRCP)检查,所有患者进行手术或逆行胰胆管造影(ERCP)检查获得病理结果。根据所有患者的影像学资料分析其肝内胆管扩张的程度、形态,肝外胆管扩张末端变化,梗阻部位及原发病性质。结果良性梗阻多为轻度胆管扩张,呈枯枝状;即使中度扩张也极少呈软藤状,而较多呈残根状。恶性梗阻多为中、重度胆管扩张,且多呈软藤状;高、中位胆道梗阻多见于恶性病变,低位胆道梗阻良性与恶性病变发生的比例相近;恶性梗阻扩张肝外胆管末端突然中断,良性梗阻扩张肝外胆管末端逐渐变细。结论磁共振胰胆管成像对良、恶性胆道梗阻病病变具有较高的诊断价值,分析胆道扩张的形态特征,对鉴别良、恶性梗阻病变有较大意义,有利于指导临床治疗。

自身免疫性胰腺炎患者胰腺内外CT和MRI表现

目的:分析自身免疫性胰腺炎(AIP)患者胰腺和胰外受累组织器官的CT和MRI影像表现。方法:回顾性分析24例AIP患者胰腺和胰外受累组织器官的CT和MRI扫描资料和临床表现。CT检查18例,MRI检查11例,CT和MRI联合检查10例。CT和MRI平扫后均行胰腺期、门脉期和延迟期三期动态增强扫描,扫描时间设定为静脉对比剂注射后35、70、180 s。结果:24例表现为胰腺弥漫性肿大,呈"腊肠样"外观6例(25.0%)、局灶性肿大9例(37.5%)、结合型6例(25.0%)、正常外形3例(12.5%)。CT平扫显示胰腺病灶区密度降低2例;增强后扫描显示受累胰实质区异常强化17例:动脉期低强化9例(50%)、延迟期延迟强化17例(94.4%)。MRI平扫显示胰腺实质信号异常9例:T1WI序列呈低信号变化7例、等信号4例,T2WI序列呈高信号变化7例、等信号2例、低信号2例;增强后扫描显示病变区异常强化11例:动脉期呈低强化9例(81.8%,9/11),延迟期延迟强化11例(100%,11/11)。胰腺周围表现为包膜样环9例(37.5%,9/24),其中CT显示6例,MRI显示7例。病灶区胰管显影消失24例(100%,24/24),病灶远侧胰管扩张8例,平均内径为(3.1±0.47)mm。胰腺段胆总管狭窄14例(58.3%,14/24)。其他:胰周静脉狭窄9例,动脉狭窄1例,胰周少量积液2例,假性囊肿3例,无一例胰实质钙化。胰外组织器官受累14例(58.3%,14/24),包括肝门部胆管狭窄5例、胆囊壁增厚5例、后腹膜纤维化2例、小肠系膜纤维化2例、肝圆韧带纤维化1例、肾受累3例、胰周和腹主动脉周围淋巴结肿大10例,以及溃疡性结肠炎3例。结论:AIP患者胰腺具有"腊肠样"外观、胰周包膜样环、延迟期延迟强化、胰管节段性狭窄而远侧段胰管扩张轻和胰外组织器官受累等一些CT和MRI的特征性征象,临床结合血清学检查和胰腺穿刺活检,常可做出正确诊断。

MRI3D-VIBE序列评价胆道梗阻性病变的价值

目的通过与磁共振胆胰管成像(MRCP)和MR梯度回波(GE)2DT1W序列增强扫描比较,探讨MRGE快速三维容积式插入法屏气检查(3D-VIBE)序列在诊断胆道梗阻性病变中的价值。方法132例疑有胆道梗阻性病变而接受包括3D-VIBE序列在内的全套MR检查患者,通过与手术、病理及临床随访结果对照,比较三种MR成像序列对胆道梗阻性病变的诊断价值。结果①病灶检测及定位:118例有明确梗阻部位,共计160个病灶中。MRCP检出149个(93.1%),优于3D-VIBE序列及2DGET1W序列(P<0.05);②定性诊断:132例患者中,三种方法准确率分别为3D-VIBE97.7%(129/132)、2DGET1W91.7%(121/132)、MRCP84.8%(112/132),3D-VIBE占优(P<0.05);③推断病灶组织学来源:三种方法准确率分别为3D-VIBE97.0%(128/132)、2DGET1W87.1%(115/132)、MRCP76.5%(101/132)。它们两两之间的差异均有统计学意义(P<0.05),3D-VIBE效果最佳。结论MR3D-VIBE序列对胆道梗阻性病变(特别是非结石性病因)显示出较佳的诊断价值。