MRI及3D-MRCP在婴幼儿胆道闭锁诊断中的影像研究  

MRI and Three-Dimensional Magnetic Resonance Cholangiopancreatography in the Diagnosis of Biliary Atresia in Infants

作　　者：姚琼[1] 管红梅[1] 李小会[1] 王圆圆[1] 徐化凤[1] 张新荣[1] 

机构地区：[1]南京医科大学附属儿童医院放射科,210008

出　　处：《临床放射学杂志》2016年第12期1876-1879,共4页Journal of Clinical Radiology

摘　　要：目的分析婴幼儿胆道闭锁的MRI及MRCP表现,评价MRI及MRCP对胆道闭锁的诊断价值。方法回顾性分析16例经手术确诊为胆道闭锁患儿的MRI及MRCP资料,观察其胆囊、肝内外胆道、肝门部结构的显示情况,对比分析患儿的MRI及MRCP表现、术中所见和术中胆道造影表现。结果 16例患儿腹部MRI及MRCP像上肝外胆道系统均未完整显示,其中胆总管均未显示。胆囊小9例,其中2例伴有胆囊结石;胆囊形态正常者4例;胆囊未见显示2例;胆囊增大合并肝门部囊肿及结石1例。肝脏汇管区周围异常信号12例;MRI冠状位见肝门部三角形T_2WI水样高信号7例;12例肝脏增大。结论 MRI及MRCP中多方位观察均未发现完整的肝外胆道时,应高度怀疑胆道闭锁;此外,胆囊小或未显示、肝脏汇管区及肝门区周围异常信号改变也具有诊断意义。Objective To analyze the MRI findings of biliary atresia（ BA） and evaluate the value of MRI and MRCP in the diagnosis of BA. Methods MR images of BA in 16 cases were retrospectively reviewed. Intrahepatic bile duct,extrahepatic bile duct,porta hepatis and gallblader were observed,to contrast the findings of MRI and MRCP、the outcome of operation and the intraoperative cholangiography. Results The biliary system in MRI / MRCP could not be visualized completely in all cases. 9 cases had a small gallbladder,2 of which had cholelithiasis. 4 cases had a normal gallbladder and one had a big gallbladder with accompanying choledocholithiasis,while the gallbladder could not be found in the other 2 cases. Exudation could be displayed in the portal area in 12 cases. In 6 cases,T_2WI showed abnormal signal around the hepatic hilar region and portal vein and in 7 cases,T_2WI showed a triangular area of high signal intensity confined to the porta hepatis on coronal plane. 12 cases had enlargement of liver. Conclusion Non-visualization of the entire extrahepatic bile duct in MR was the most common feature of BA in MRI. Therefore,a small gallbladder or non-visualization of the gallbladder 、exudation in portal area and abnormal signal around hepatic hilar or the liver portal region can aid in the accurate diagnosis of BA.

关 键 词：磁共振胆胰管造影 磁共振成像 胆道闭锁 婴幼儿 

分 类 号：R726.5[医药卫生—儿科] R445.2[医药卫生—临床医学]