胰头癌的MRCP临床诊断的特异征象  

The Special Sign of MRCP in Carcinoma of Pancreatic Head

作　　者：席永昌[1] 席大鹏[2] 赵吉生[3] 房学东[3] 

机构地区：[1]吉林大学中日联谊医院放射科,吉林长春130031 [2]吉林大学中日联谊医院放疗科,吉林长春130031 [3]吉林大学中日联谊医院基本外科,吉林长春130031

出　　处：《实用放射学杂志》2005年第9期923-925,共3页Journal of Practical Radiology

基　　金：吉林省科技厅资助科研课题(课题编号:20030431)

摘　　要：目的研究探讨MRCP对胰头癌的临床诊断的特异征象。方法经手术和病理证实22例胰头癌病例的术前MRCP检查,扫描序列包括SE序列T1WI、FSE序列T2WI、T1WIFS、T2WIFS、MRCP冠状位扫描成像。16例术前行CEMRA肠系膜血管三期扫描成像,显示腹腔动脉、门静脉及肠系膜血管。结果本组21例胰头癌通过MRCP扫描诊断为胰头癌,1例胰头癌误诊为慢性胰头炎。MRCP确诊率为95.4%。本组22例胰头癌MRCP上均有胆总管和主胰管胰头段,因癌瘤侵袭而破坏截断其残留段信号示增高且扩张征象,而且示残存之胆总管与残留主胰管不相交的征象,称之“不相交征”,这是确诊胰头癌的MRCP特异征象。CEMRA显示腹腔动脉、门静脉和肠系膜上静脉受到肿瘤侵袭破坏者分别为3例、3例和4例。结论MRCP扫描“不相交征”对胰头癌诊断有重要作用。Objective To research the special manifestations of magnetic resonance eholangiopanereatography（MRCP） in carcinoma of pancreatic head. Methods MRCP in 22 cases with pancreatic head carcinoma confirmed by operation and pathology （ including SE sequences with TIWI and fat saturation, FSE with T2WI and fat saturation and MRCP in coronal seetior） were performed before operations. Additional CE MRA on abdominal vessels including abdominal ateries, portal veins and superior mesenterie arteries and their veins in 16 cases also examined before operations. Results Carcinomas of the pancreatic head were diagnosed correctly by MRCP in 21 cases, and 1 case was misdiagnosed as chronic panereatitis. MRCP all demonstrated abrupt interruption at pancreatic head segments of dilated left common bile duct and main pancreatic duct at the pancreatic head ones, their left segments were dilate with higher signal and both didn＇ t cross each other, because they were destroyed by carcinomas of pancreatic head. Destruction and no cross each other of pancreatic head segments of eholedoehus and main pancreas duet,it was called “no cross sign ”. CE MRA demonstrated destruction of abdominal ateries in 3 cases, portal vein in 3 cases and superior mesenterie vein in 4 cases and not being reseeted. Conclusion “No cross sign” on MRCP examination is of important value in diagnosis of carcinoma of the pancreatic head.

关 键 词：胰腺 胰头癌 磁共振胰胆管成像 

分 类 号：R735.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]