|
［Abstract］ Objective To evaluate the clinical diagnostic value of magnetic resonance cholangiopancreatography(MRCP) in diagnosis of malignant biliary obstruction,and their value in differential diagnosis. Methods MRCP data of 74 cases of malignant biliary obstruction proved by surgical pathology and clinical result were analyzed retrospectively,MRCP was performed using singleshotradio SE sequence on all 74 cases.Of all cases included primary gallbladder carcinoma in 2,metastases in 7,cholangiocarcinoma in 49,carcinoma of head of pancreas in 16. Results MRCP was succeeded at one time in all cases.On MRCP,the visual rate of intrinsic and extrinsic hepatic bile duct was 100％.The localized and qualitative diagnosis of lesions were up to 93.2％,89.2％ retrospectively. Conclusion MRCP is a noninvasive technique for depicting the normal and abnormal pancreaticobiliary duct,and if had the excellent accuracy in the determination of the locations and causes.
［Key words］ malignant biliary obstruction;cholangiopancreatography;magnetic resonance imaging
磁共振胰胆管成像（MRCP）是一种新的无创性的胰胆管检查技术，能够清楚地显示肝内外胆管及胰管的解剖结构，对胰胆管疾病的诊断具有很高的诊断价值［1］，已广泛应用于诊断胆道结石、胰胆管肿瘤、胆道和胰腺的炎症以及术后的随访等［2～6］。笔者通过对74例恶性胆道梗阻性疾病的MRI和MRCP的成像资料进行回顾性分析，探讨其在恶性胆道梗阻性疾病诊断中的应用价值，旨在提高诊断的准确率。
1 资料与方法
1.1 一般资料 收集我院1998年以来经MRI和MRCP检查并为手术病理或临床证实的恶性胆道梗阻74例，男49例，女25例；年龄41～83岁，平均66.2岁，病程7～180天，平均36天。其中胆管癌49例，胰头癌16例，转移癌7例，胆囊癌肝门部侵犯2例。
1.2 检查方法 MRI为GE公司0.2 T常导型磁共振成像仪，采用相匹配的体部相控阵列线圈及呼吸门控。患者检查前空腹，禁食。在获得MRCP前，肝脏常规扫描，范围自膈顶至肝下缘，行SE序列横轴位相T1WI（TE=14 ms,TR=440 ms）、T2WI（TE=88 ms,TR=3750 ms）,T1WI脂肪抑制相，常规层厚8 mm，间隔2 mm。动态增强扫描团注顺磁性对比剂（GdDTPA）15 ml。MRCP采用单次激发放
射状自旋回波序列技术，扫描时屏气，TR/TE=8000 ms/800 ms，FOV 250 mm，RFOV 100％，矩阵256×256，采集次数为1次，层厚40 mm，可对图像进行连续多角度多方位观察。
|
