利用磁共振胰胆管成像对晚期医原性肝外胆管狭窄进行术前评估  

Evaluation of late stage iatrogenic extraheptic bile duct stricture by using magnetic resonance cholangiopancreagraphy

作　　者：孙昌进[1] 周翔平[1] 刘荣波[1] 宋彬[1] 王文涛[2] 严志汉[1] 熊燕[3] 陈宪[1] 许民生[4] 顾建平[4] 

机构地区：[1]四川大学华西医院放射科,成都研究生现在610041 [2]四川大学华西医院普外科,成都610041 [3]成都铁路中心医院放射科 [4]南京医科大学附属南京第一医院放射影像科

出　　处：《中华放射学杂志》2003年第2期127-130,共4页Chinese Journal of Radiology

摘　　要：目的　探讨磁共振胰胆管成像 (MRCP)对晚期医源性肝外胆管狭窄的磁共振胆胰管成像的术前评估价值。方法　对 18例MRCP诊断为晚期医源性肝外胆管狭窄并经手术病理证实的患者进行分型及术前手术方式选择 ,并与手术记录对照分析。结果　 18例中能够按照Bismuth分型法进行分型者 17例 ,其中Ⅰ型 3例 ,Ⅱ型 7例 ,Ⅲ型 3例 ,Ⅳ型 3例 ,1例Ⅱ型狭窄被误分为Ⅲ型 ,MRCP分型准确 16例。根据术前MRCP提供的信息 ,术中 16例采取了正确的手术方法 ,2例未能采用预期的手术方式。MRCP术前手术方式选择准确 16例。Objective To assess the role of magnetic resonance cholangiopancreagraphy (MRCP) in the preoperative evaluation of late stage iatrogenic extraheptic bile duct stricture. Methods Eighteen cases, which were diagnosed as late stage iatrogenic extraheptic bile duct strictures only by MRCP and proved by surgery and pathology, were classified according to Bismuth classification and the surgical operation strategy was planed on the basis of MR cholangiopancreagraphic findings before surgery. The results were compared with surgery. Results Diagnostic MR Cholangiopancreagrams were acquired in 18 patients. Among all 18 patients, the level of stricture was classified as BismuthⅠin 3 patients, BismuthⅡin 7 patients, Bismuth Ⅲ in 3 patients, and Bismuth Ⅳ in 3 patients. A BismuthⅡstricture was incorrectly classified as a Bismuth Ⅲ lesion. On the basis of MR cholangiopancreagraphic findings, a surgical operation strategy can be planed. The therapeutic plan anticipated with MRCP matched the actually used procedure in 16 of 18 patients. Conclusion MRCP plays an important role in the evaluation of late stage iatrogenic extraheptic bile duct stricture.

关 键 词：肝外胆管狭窄 术前评估 胆管疾病 NMR 成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]