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1、MRCP对胰胆管系统病变的临床应用作者:土旭,郝春姐,郭苏晋,刘军,曾小兵单位:辽宁瓦房店,瓦房店市第三人民医院CTMR室陕西西女,解放军第323医院医学影像科【关键词】MRCP胰胆管系统病变临床应用ClinicalapplicationofMRCPsequencesinpancreaticobiliarydiseasesWANGXu,HAOChun-juan,GUOSu-jin,etal.TheThirdPeoplesHospitalofWafangdian,Wafangdian116300,China[Abstract]Ob
2、jectiveToevaluatethediagnosticvalueofmagneticresonancecholangliopancreatography(MRCP)indeterminatingthelocationandnatureofpancreaticobiliaryductdiseases.MethodsMRCPwereperformedin426casessuspiciouspancreaticobiliaryductdiseases,jaundiceand/orclinicalpainonasupercondu
3、ctiveMRscanner(Siemenssymphonyp1.5T),WhencombinedwithTrueFISP(axialpositionas)andTSE-MRCP(thinlayeroftheoriginalfaultascoronal)comprehensiveanalysisdefinition.ResultsTheaccuracyindeterminatingthelocationofMRCPinpancreaticobiliaryductdiseaseswas100%;thesensitivityforc
4、alculidefinitionwas98.4%;thesensitivityfortumor(includingthebileductpolyp)was92.6%;congenitalbileductcystsshowedthattheratewas100%;biliarydiseaseontheshowratewas97.3%.ConclusionDifferentcausesofobstructionhavetheirowncharacteristicmanifestations,MRCPsequencesclearlya
5、ndintuitively,three-dimensionallydisplaypancreas,bileductanatomy,canaccuratelyevaluatepancreaticobiliarydiseases,biliarysystemforavarietyofdiseaseshasimportantclinicalvalue.[Keywords]magneticresonancecholangliopancreatography;bileductdiseases;Hoffmannsductdiseases磁共振
6、胰胆管造影(magneticresonancecholangliopancreatography,MRCP)是一种非介入性胆管成像技术,近年来已广泛应川于胰胆系统疾病的诊断,为胰胆道梗阻性病变的影像学诊断开辟了新的领域,具有较高的嫩感性、特异性和准确性。近两年来,我院对426例胰胆管系统疾病患者进行了MRCP检查,获得了满意的效果,现报告如下。1资料与方法1.1一般资料2006年II月至2008年6月我院MRCP检查患者426例,全部病例均为临床怀疑或证实胰胆管疾病患者,男207例,女219例,年龄80天〜76岁,平均54岁。其
7、中298例经PTC及ERCP、活检或手术及腹腔镜病理证实,包括胰腺癌34例,十二指肠壶腹癌12例,胆管癌26例,胆囊癌17例,肝内胆管细胞癌17例,胆系结石184例,胆道蛔虫症3例,胆总管囊肿合并胆管癌1例,胆总管囊肿合并结石5例,于术前2周行MRCP检查(部分肿瘤患者加增强扫描),另外包插外伤性胰腺导管断裂1例,术中证实;其余128例未经病理证实,其中胰头癌伴肝转移3例;壶腹癌2例,胆管癌3例,肝内月I!筲细胞癌2例,胆总管囊肿3例,肝移植术后评佔胆道吻合情况13例,胰腺炎8例,有上腹痛症状影像学无明显异常30例,胆囊术后复查
8、单纯胆道扩张33例,急性胆囊炎胆囊窝明显渗出10例。1.2MR方法与技术使川SIEMENSSYMPHONYP1.5T超导MRI机进行扫描检査,选川腹部相控线圈,呼吸门控技术,常规仰卧位,平静呼吸,腹带加压,所有患者检查前空腹6〜8h;MRCP检杳以常规横轴位真稳