MRCP对梗阻性黄疸诊断价值探析.doc

MRCP对梗阻性黄疸诊断价值探析 　【摘要】 　　目的 探讨磁共振胰胆管成像（MRCP）对梗阻性黄疸疾病的诊断价值。方法 回顾性分析经手术或ERCP病理证实的梗阻性黄疸患者资料119例。该119例梗阻性黄疸患者用西门子1.5T超导型磁共振成像仪行常规MRI及MRCP检查。常规MRI包括轴位T1WI、T2WI及T2 trufi冠状位扫描；MRCP检查包括3D MRCP和二维厚块MRCP检查。结果 良性病变98例，其中胆系结石80例，胆管炎性狭窄12例，胆总管蛔虫4例，胆总管囊肿2例。恶性病变21例，其中胆管癌11例， 壶腹癌3例，胰头癌7例。MRCP能清晰地显示正常胰胆管树结构，能直观地显示胰胆管扩张和梗阻的部位、形态、范围，对梗阻性胆道疾病的定位诊断准确率为100%，定性诊断准确率为94%。结论 MRCP对梗阻性黄疸定位、定性诊断准确，特别是对结石的诊断，能清楚地显示梗阻部位、原因、病变形态、病变与周围结构的关系及周围病变性质，为临床手术方案提供可靠依据。 【关键词】 磁共振成像；胰胆管成像；梗阻性黄疸；诊断 　　Abstract： Objective To explore the diagnostic value of magnetic resonance cholangiopancreatograpy (MRCP) in patients with obstructive jaundice. Methods A total of 119 patients with obstructive jaundice confirmed by surgical operation, endoscopic retrograde choledochopancreastography (ERCP) and pathology were retrospectively analyzed.Routine magnetic resonance imaging ( MRI) and MRCP examination were carried out on them with 1.5 T Siemens super-conductive magnetic resonance machine. MRI included T1 weighted imaging and T2 weighted imaging in axial plane and T2 trufi imaging in coronal plane. MRCP consisted of three-dimensional MRCP and two-dimensional MRCP. Results Among the 119 cases, 98 were benign lesions, of which 80 were gallstone, 12 cholangitic stenosis, 4 roundworms of bile duct, and 2 congenital choledochal cyst. There were 21 malignant cases including 11 of cholangiocarcinoma, 3 of ampullary carcinoma, 7 of carcinoma of head of pancreas. MRCP displayed clearly the normal pancreaticobiliary duct, and showed directly the position, form and scope of the obstruction or dilatation of the pancreaticobiliary duct. The diagnostic accuracy of MRCP displaying obstructive level was 100%, with a qualitative diagnostic accuracy of 94%. Conclusion MRCP can display accurately the location and the nature of obstructive jaundice. Especially for the diagnosis of gallstone, MRCP can display the locus and the cause of obstruction, the form of lesion and the relationship with surrounding structures. It provides the depend