磁共振胆胰管成像显示胆囊罗-阿窦的影像病理对照分析  

Analysis of Imaging Manifestations of Gallbladder Rokitansky-Aschoff Sinus on Magnetic Resonance Cholangiopancreatography and Correlated with Pathology

作　　者：王冬女[1] 汪军峰[1] 朱华勇[1] 肖明[2] 

机构地区：[1]台州医院放射科,浙江317000 [2]台州医院病理科,浙江317000

出　　处：《放射学实践》2009年第11期1240-1242,共3页Radiologic Practice

摘　　要：目的:探讨磁共振胰胆管成像(MRCP)显示胆囊罗-阿窦(RAS)的影像学表现及其病理特征。方法:45例胆囊腺肌增生症(GBA)患者,术前均行MRCP检查,常规采用单次激发FSE(SS-FSE)重T2WI序列和稳态采集快速成像(FIESTA)序列行冠状面扫描。将45例患者的MRCP表现和病理学资料进行对照,分析罗-阿窦的影像学特征及其病理基础。结果:45例中MRCP显示胆囊壁局限性变形、增厚43例,弥漫性增厚2例;增厚的胆囊壁内均见多个小囊状憩室样结构环状排列呈典型的"花环征",其内呈高信号。术后病理诊断为GBA并慢性胆囊炎45例,其中35例合并胆囊结石;罗-阿窦的病理表现为肌层内异位腺体,周围有增生的平滑肌组织环绕或伴神经纤维增生性改变。结论:MRCP可清晰显示GBA伴慢性胆囊炎患者胆囊壁罗-阿窦的形态特征,正确选择敏感无创的影像学检查方法和仔细观察罗-阿窦形态特征是GBA早期诊断和治疗的关键。Objective：To analyze the imaging features of gall bladder Rokitansky Aschoff sinus （RA sinus） on magnetic resonance eholangiopancreatography （MRCP） as well as its pathology characteristics. Methods： Forty five patients with gallbladder adenomyosis hyperplasia （GBA） underwent MRCP before surgery. Single shot fast spin-echo （SS-FSE） sequence of heavy T2WI and fast imaging employing steady state acquisition （FIESTA） sequence on coronal plane were per formed routinely,the MRCP manifestations were analyzed and correlated with pathology. Results： Of the 4,5 patients, focal deformation and thickening of gallbladder wall were revealed in 43 patients and diffuse gall bladder wall thickening in 2 patients. Multiple small cyst/diverticulum like structure with high signal intensity on T2 WI arranged in the thickened gallbladder wall showing a typical ＂garland-sign＂ can be assessed. The pathology diagnosis after surgery were GBA combined with chronic cholecystitis in all of the 45 patients, accompanied cholecystolithiasis were shown in 35 patients. The histological features of R-A sinus were ectopie intramural gland, encircling with smooth muscle or nerve fiber prohferation. Conclusion： The morphology characteristics of RA sinus could be clearly detected on MRCP in patients having GBA accompanied with chronic cholecystitis. To choose a non-- invasive and sensitive imaging technique is the key point in precise assessing the morphology as well as early diagnosis and treatment of GBA.

关 键 词：磁共振胆胰管成像 罗-阿窦 胆囊腺肌增生症 慢性胆囊炎 

分 类 号：R657.4[医药卫生—外科学] R734.2[医药卫生—临床医学]