磁共振胆胰管成像对胆囊三角粘连的术前评估  

Preoperative Evaluation on Calot's Triangle Adhesion by Magnetic Resonance Cholangiopancreatography

作　　者：孙荣勋[1] 陈江[1] 吉学生[2] 刘景田[1] 张大伟[1] 武广斌[1] 李小燕[1] 孙培龙[1] 

机构地区：[1]复旦大学附属金山医院普外科,上海201508 [2]复旦大学附属金山医院放射科,上海201508

出　　处：《中国临床医学》2014年第5期570-571,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨磁共振胆胰管成像(magnetic resonance cholangiopancreatography,MRCP)用于腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)术前评估胆囊三角粘连的价值。方法:对254例LC患者术前行MRCP检查,评估胆囊三角粘连的类型,包括胆囊管是否显示、胆囊管和胆囊壶腹的毗邻关系以及胆囊管在胆囊壶腹的开口位置。将术前评估的胆囊三角粘连的类型与LC术中确认的类型进行对比,并分析术前评估类型与手术难度的关系。结果:MRCP对胆囊三角粘连类型的术前评估与LC术中所见相同。胆囊管和胆囊壶腹呈兔尾型的毗邻关系、胆囊管开口于胆囊壶腹中份以及胆囊管未显影,均预示着LC实施困难。结论:MRCP可以对胆囊三角粘连类型进行术前评估,有助于预测手术难度。Objective：To investigate the value of magnetic resonance cholangiopancreatography（MRCP）in the evaluation on Calot’s triangle adhesion before laparoscopic cholecystectomy（LC）.Methods：A total of 254 patients received MRCP before LC,and the type of Calot’s triangle adhesion was evaluated,which included whether or not the cystic duct had been displayed, adjacent relations between the cystic duct and the gallbladder ampulla,and the open position of the cystic duct in the gallbladder ampulla.The type of Calot’s triangle adhesion by preoperative evaluation was compared with that by intraoperative findings. The relation between the type by preoperative evaluation and the difficulty of operation was analyzed.Results：The type of Cal-ot’s triangle adhesion by preoperative MRCP corresponded with that by intraoperative findings.The rabbit tail type of adjacent relation between the cystic duct and the gallbladder ampulla,the cystic duct starting at the middle portion of the gallbladder am-pulla and the absent imaging of cystic duct could indicate difficult LC procedures.Conclusions：MRCP could be used in preoper-ative evaluation on Calot’s triangle adhesion,to predict the difficulty degree of the LC procedure.

关 键 词：磁共振胆胰管成像 腹腔镜胆囊切除术 胆囊三角 粘连 

分 类 号：R445.2[医药卫生—影像医学与核医学]