先天性胆管扩张的鉴别诊断  

Magnetic resonance cholangiopancreatography in pediatric congenital biliary dilation

作　　者：曹卫国[1] 干芸根[1] 孙龙伟[1] 李志勇[1] 李玲琼[1] 

机构地区：[1]广东省深圳市儿童医院放射科,广东深圳518038

出　　处：《医学影像学杂志》2016年第3期460-463,共4页Journal of Medical Imaging

摘　　要：目的探讨磁共振胆胰管造影(MRCP)诊断儿童先天性胆管扩张的临床价值。方法回顾性分析78例先天性胆管扩张患儿的MRI和MRCP表现,并与手术病理结果进行对照分析。结果先天性胆管囊肿76例,Ⅰ型33例,Ⅱ型2例,Ⅲ型0例,Ⅳ型41例,Ⅴ型0例,囊肿型胆道闭锁2例;先天性胆管囊肿常合并胆囊扩大(53.9%),胆汁淤积(75%)和结石(42.1%);囊肿型胆道闭锁其胆管扩张局限,肝门部及门静脉周围可见局限斑片状长T_2信号,无胆囊扩大,胆汁淤积和结石等合并症。结论 MRCP能正确诊断先天性胆管扩张,可有效鉴别诊断先天性胆管囊肿和囊肿型胆道闭锁。Objective To analyze the value of magnetic resonance cholangiopancreatography （ MRCP） in diagnosing pediatric congenital biliary dilation .Methods MRCP and MRI images were assessed retrospectively in 78 children were confirmed biliary dilation by laparoscopic exploration and surgical pathology .Results Congenital biliary dilatation （ CBD） 76 cases,according to the Todani,s classification, typeⅠ33 cases, typeⅡ2 cases, type Ⅳ41 cases, type Ⅲ and Ⅴ0 cases.Cystic biliary atresia （CBA） 2 cases.There were Gallbladder enlargement （53.9%）, cholestasis （75%） and bile duct stone （42.1%） in CBD chil-dren.There were limitations of dilated bile duct , patchy long T2 WI signal around hepatic portal and portal vein , while no expan-sion of the gallbladder in CBA .Conclusion MRCP can precisely diagnosis pediatric congenital biliary dilation before surgey , which is an effective way to differentiate CBA from CBD .

关 键 词：磁共振成像 胰胆管造影 儿童 胆管扩张 

分 类 号：R445.2[医药卫生—影像医学与核医学] R657.4[医药卫生—诊断学]