MRI 在十二指肠乳头腺癌中的诊断价值  

MRI findings of papillary adenocarcinoma of the duodenum

作　　者：蒋志琼[1] 吴碧华[1] 肖波[2] 

机构地区：[1]川北医学院附属医院老年科,四川南充637000 [2]川北医学院附属医院放射科,四川南充637000

出　　处：《世界最新医学信息文摘》2014年第15期162-163,共2页World Latest Medicine Information Electronic Version

基　　金：四川省卫生厅科研课题资助项目（110296）

摘　　要：目的探讨十二指肠乳头腺癌的MRI表现。方法回顾性分析2010年1月1日至2013年6月1日间我院行腹部MRI检查的连续性病例，共收集病理诊断为十二指肠乳头腺癌者12例（男：女=7：5，年龄48岁-68岁、平均56．4岁）。临床以全身或皮肤巩膜黄染、上腹痛等就诊。所有病人行GE1．5TMRI检查前均签署知情同意书，扫描包括梯度回波T1加权、单次激发快速自旋回波T2加权、MRCP、3D-LAVA动态增强扫描。在MR工作站上观察胰胆管梗阻平面，十二指肠壁是否增厚、十二指肠乳头部是否增大及信号增强特征；肝内外胆管扩张情况；胆囊是否增大，胆囊壁有否增厚和强化特征；主胰管扩张情况，胆总管和主胰管扩张程度是否成比例（计数胆总管最大直径／主胰管最大直径的比值）。结果12例十二指肠乳头腺癌表现十二指肠乳头结节状增大伴静脉期／延迟期强化和十二指肠壁局限性环状增厚累及十二指肠乳头者占66．7％（8／12），表现胰头钩突肿块者占25％（3／12），表现胆总管下段近乳头部结节状影伴强化者占8．3％（1／12）。胰胆管梗阻于十二指肠乳头部者占83.3％（10／12）。肝内外胆管扩张占91．7％（11／12），主胰管扩张占83．3％（10／12）；胆总管最大径／主胰管最大径兰5倍者占50％（6／12）。MRI诊断十二指肠乳头肿瘤正确率为66．7％（8／12）。结论MRI诊断十二指肠乳头部肿瘤的准确率较高，十二指肠乳头腺癌具备一些较特异的MRI征象。Objective To investigate the MRI findings of papillary adenocarcinoma of the duodenum. Methods Patients in our hospital under abdominal MRI examination between January 1, 2010 to June 1, 2013 were retrospectively analyzed. 12 patients of duodenal adenocarcinoma diagnosed by pathology were collected. All patients undergoing GE 1.5T MRI examination had signed an informed consent form. Bile and pancreatic duct obstruction plane, the thickening duodenal wall and the increased duodenal papilla and the signal enhanced features, the extrahepatic bile duct dilatation, the increased gallbladder and the thickening gallbladder wall and enhanced features, the main pancreatic duct dilatation, the extent of the common bile duct and main pancreatic duct dilatation proportional were observed at MRI workstation. Result In 12 cases of duodenal adenocarcinoma, eight cases （ 66.7% ） performed increased nodular duodenal papilla with delay strengthened and the limit round-like thickening of the duodenal wall duodenal involved duodenal papilla. Bile and pancreatic duct obstruction in the duodenal papilla accounted for 83.3% （ 10/12 ） , hepatic bile duct dilatation accounted for 91.7% （ 11/12 ） , increased gallbladder volume accounted for 91.7% （ 11/12 ） , main pancreatic duct dilatation accounted for 83.3% （ 10/12 ） , and the maximum diameter of the common bile duct/maximum diameter of the main pancreatic duct ≥ 5 accounted for 50% （ 6/12 ） . The accuracy of MRI diagnosis of duodenal papilla cancer accounted for 66.7% （ 8/12 ） . Conclusion MRI diagnostic accuracy rate for duodenal papilla cancer may be high, and papillary adenocarcinoma of the duodenum had some specific MRI signs.

关 键 词：十二指肠乳头 腺癌 壶腹周围癌 MRI 

分 类 号：R445.2[医药卫生—影像医学与核医学] R574.51[医药卫生—诊断学]