胰胆管汇合MRCP解剖与胰胆系疾病关系  

MRCP study of Pancreaticobiliary Maljunction and Pancreaticobiliary Diseases

作　　者：程琳[1,2] 余永强[1] 王成林[2] 张子钦[2] 谢婷婷[2] 丁贺宇[2] 

机构地区：[1]安徽医科大学第一附属医院放射科,安徽合肥230022 [2]北京大学深圳医院影像中心,广东深圳518036

出　　处：《中国CT和MRI杂志》2012年第1期50-53,共4页Chinese Journal of CT and MRI

基　　金：深圳市科技计划项目(项目编号:201102003)

摘　　要：目的探讨胰胆管汇合的分型、发生率及异常汇合与胰胆系疾病的关系。方法统计来我院进行磁共振胆胰管成像检查,符合测量和诊断要求的694例为研究对象,采用单次激发FSE序列,采用最大密度投影获得MRCP图像。结果根据胰胆管汇合部解剖形态,将胰胆管汇合分为正常型和异常型,其中异常型又可分为P-B型、B-P型及分别开口型。在正常型和异常型两组之间,胆系结石和胆囊炎、胰腺炎、胆系肿瘤、胰腺肿瘤的发生率有明显差异(P<0.05),异常型更易发生胰胆系疾病。异常型中的各型合并胰胆系疾病的发生率,经fisher精确检验显示胆系结石、胆囊炎和胰腺肿瘤三组间无显著性差异(P>0.05),B-P型和P-B型的胰腺炎明显高于分别开口型(P<0.05),而B-P型胆系肿瘤明显高于P-B型、P-B型明显高于分别开口型(P<0.05)。正常型和异常型合并先天性胆总管扩张的发生率相近(P>0.05),无显著性差异。结论 PBM很容易合并胰胆系疾病,特别是胰腺炎、胰胆系肿瘤的发生明显增多,MRCP检查有利于胰胆管汇合部的分型诊断,可为该部位病变的定位和定性诊断、胰胆系疾病早期诊断与预防性治疗提供重要信息。Objective To discuss the imaging anatomy about the convergence of the pancreaticobiliary duct,types of the Pancreaticobiliary maljunction（PBM） and associated diseases in Chinese population by using magnetic resonance cholangiopancreatography（MRCP） examination.Method Data were collected from 963 patients that performed with MRCPs from January 2010 to December 2011.All cases were examined by single shot FSE sequence（fast spin-echo）.The maximum intensity projection（MIP） were used in order to obtain MRCP images.Result We analyzed the anatomy of pancreaticobiliary junction based on MRCP images,and then classified the types of the pancreaticobiliary junction to normal type and abnormal type.Abnormal type can be further divided into P-B type,B-P type and the duodenum type.We analyzed the incidence of the biliary stone and inflammation,pancreatitis,malignancy of biliary tree as well as pancreatic carcinoma between normal and abnormal group and found no significant differences（P0.05）.Abnormal group is more likely to suffer from pancreaticobiliary dieseases.We compared different types of PBM that associated with the pancreaticobiliary diseases by using fisher＇s method and shows there are no significant differences between biliary stone,cholecystitis and pancreatic carcinoma（P0.05）,pancreatitis in B-P type and P-B type are higher than in the duodenum type（P0.05）,malignancy of biliary tree in B-P type are more than in P-B type whereas the malignancy of biliary tree in the duodenum type are less than in P-B type（P0.05）.The incidence of the congenital choledochal cyst in both normal type and abnormal type are similar.There are no significant difference between two groups（P0.05）.Conclusion The types of PBM are closely related to the occurrence of pancreaticobiliary diseases,particularly pancreatitis,tumor of biliary tree and pancreatic tumor.MRCP imagines can be used in the diagnosis of the ancreaticobiliary diseases such as assisting to display the position of anormaly and to define differ

关 键 词：胰胆管汇合异常 磁共振胆胰管成像 胆系 胰腺 

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