胆囊管变异与胆囊结石相关性的MRI研究  

The Relationship between Anatomic Variations of the Cystic Duct and Gallstone:an MRI Study

作　　者：张仕勇[1] 黄小华[1] 敬宗林[1] 董国礼[1] 刘念[1] 雷力行[1] 

机构地区：[1]四川省南充市川北医学院附属医院放射科

出　　处：《中国医学计算机成像杂志》2015年第2期145-148,共4页Chinese Computed Medical Imaging

摘　　要：目的:利用磁共振胰胆管造影(M RCP)及常规M R I序列,探讨胆囊管变异与胆囊结石发生的相关性。方法:回顾性分析符合纳入标准的382例患者的MRI及临床资料,比较常见变异胆囊管与正常胆囊管患者胆囊结石患病率差异。胆囊管变异由两位影像医师根据MRI常规及2D-MRCP序列独立盲法诊断,胆囊结石经手术或MRI和B超检查共同证实。结果:正常胆囊管154例,胆囊管变异228例(变异率59.7%),其中胆囊管高位汇合20例,汇合于肝总管前或后壁130例,中间汇合24例,低位汇合16例,平行胆囊管20例,胆囊管低位汇合伴胆囊管平行走行11例,短胆囊管7例。变异胆囊管中,胆囊管低位汇合和胆囊管低位汇合伴胆囊管平行走行患者结石患病率(分别为68.8%、63.4%)较正常胆囊管患者差异有统计学意义(P=0.000、0.003),胆囊管高位汇合、汇合于肝总管前或后壁、中间汇合、平行汇合、短胆囊管患者胆囊结石患病率(分别为20.0%、26.9%、25.0%、40.0%、0)较正常胆囊管患者差异不具有统计学意义(P>0.05)。结论:胆囊管变异率较高,变异胆囊管中,胆囊管低位汇合、胆囊管低位汇合伴胆囊管平行走行是促进胆囊结石形成的危险因素。Purpose：To evaluate the role of the anatomic variations of the cystic duct（AVCD） in the formation of gallstone by magnetic resonance cholangiopancreatography（MRCP） and conventional MRI sequences.Methods：The MRI and clinical data of 382 patients,who were in accordance with the inclusive criteria,had been analyzed retrospectively.The images of 2D-MRCP and conventional MRI sequences were analyzed independently by two radiologists,the anatomic variants of cystic duct were diagnosed in a blinded way.The gallstone was confirmed by operation or both MRI and ultrasound.The prevalence rate of gallstone in patients with AVCD and normal cystic duct（NCD） was compared.Result：One hundred and fifty-four patients were with NCD.And anatomic variants were observed in 228 patients（59.7%）,including high insertion in 20,posterior or anterior insertion in 130,medial insertion in 24,low insertion in 16,parallel cystic duct in 20,parallel cystic duct with a low insertion in 11,short cystic duct in 7.Low cystic duct insertion and parallel cystic duct with low insertion showed with significant high prevalence rate of gallstone（68.8%,63.4%） when they were compared with NCD group respectively（p=0.000,0.003）.The difference of prevalence of gallstone between that in high insertion（20.0%）,posterior or anterior insertion（26.9%）,medial insertion（25.0%）,parallel cystic duct（40.0%） and in NCD was with statistical significant（P〉0.05）,and none of 7 short cystic duct was with gallstone.Conclusion：There is a high incidence of the AVCD.Among these variations,low cystic duct insertion and parallel cystic duct with a low insertion are risk factors for gallstone.

关 键 词：胆囊结石 胆囊管变异 磁共振胆胰管造影 

分 类 号：R575.6[医药卫生—消化系统] R445.2[医药卫生—内科学]