磁共振胰胆管成像在胰胆管疾病诊断中的应用价值  

Clinical application of MRCP in the diagnosis of pancreaticobiliary duct diseases

作　　者：刘继华[1] 

机构地区：[1]天津中医药大学第一附属医院放射科,天津300193

出　　处：《实用医学影像杂志》2010年第2期94-97,共4页Journal of Practical Medical Imaging

摘　　要：目的探讨磁共振胰胆管成像(MRCP)在胰胆管疾病诊断中的临床应用价值。方法采用重T2加权多次激发对100例临床拟诊胆道梗阻的患者进行MRCP检查,并经手术病理或其他影像学或临床资料证实。恶性梗阻28例,其中胰头癌9例,壶腹癌6例,胆管癌10例,原发性肝细胞癌直接侵犯3例;良性梗阻72例,其中胆总管结石33例,胆囊切除术后狭窄5例,胆囊炎或结石26例,慢性胰腺炎4例,先天性胆总管囊肿2例,硬化性胆管炎2例。结果 MRCP较清晰地显示了各种胰胆管疾病的部位和形态。本组定位诊断准确率为85%。MRCP的诊断敏感性为75%,特异性为83%,准确性为81%,阳性预测值为85%,阴性预测值为93%。结论 MRCP对于胆道梗阻性病变的定位较为准确,结合MRI平扫及资源像,定性诊断也有一定的特异性,是一种安全、无创的检查手段,能为临床诊治提供可靠依据。Objective To evaluate the diagnostic value of magnetic resonance cholangiopancreatography （MRCP） in determing the location and nature of pancreaticobiliary duct diseases （PBDDs）. Methods A hundred patients with surgically and pathologically or clinically proved PBDDs which comprised 28 cases of malignant lesions （9 pancreatic head carcinomas, 6 ampullary carcinomas, 10 bile duct carcinomas, 3 primary hepatocellular carcinomas） and 72 cases of benign lesions （33 choledocholithiasis, 5 postoperative gallbladder stricture, 26 cholecystitis or cholelithiasis, 4 chronic pancreatitis, 2 congenital choledochocyst and 2 sclerotic cholangitis） underwent MRCP examinations. The procedure was performed by using heavily T2 weighted HASTE sequence. Results MRCP could clearly visualize the site and shape of PBDD lesions. The localized accuracy of MRCP for PBDD lesions was 85 %. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of MRCP in the group patients were 75%, 83.3%, 81%, 84.8%, and 93%, respectively. Conclu- sion MRCP has higher accuracy in the localized diagnosis of PBDDs, while its combination with conventional MRI and resource images has higher specificity for the qualitative diagnosis, simultaneously, it is a safe and non-invasive modality which can provide the reliable evidence for clinical diagnosis and treatment.

关 键 词：胰胆管疾病 磁共振胰胆管成像 病理 鉴别诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575.7[医药卫生—诊断学]