常规MRI扫描结合胰胆管造影在胆道梗阻性疾病中的应用

【】　目的　探讨常规MRI扫描及胰胆管造影（MRCP）对胆管梗阻性疾病的临床诊断价值。　方法　2006年4月-2010年6月，对59例胆管梗阻性疾病患者行常规MRI及MRCP检查，其中18例行动态增强扫描，并与临床诊断或手术、病理结果对照分析。MRCP采用不屏气厚层快速自旋回波（FSE）序列重度T2WI扫描，原始图像以最大信号强度投影（MIP）法进行三维重建。　结果　MRI及MRCP对胆管梗阻程度的判断和定位诊断准确率为100.0%，定性诊断准确率为91.5%，其中MRCP诊断胆管结石和恶性胆管梗阻的准确率分别为96.8%和86.9%。　结论　MRCP对胆管梗阻的定位诊断准确，结合3D原始图像、常规MRI扫描及动态增强扫描，对胆管结石和恶性胆管梗阻的定性诊断有很高的准确性。【Abstract】　Objective　ToevaluatetheclinicaldiagnosisvalueofMRIandcholangiopancreatography(MRCP)indiagnosisofbiliaryobstructivedisease.　Methods　RoutineMRIandMRCPwereperformedon59patientsbetweenApril2006andJune2010,inwhichdynamicenhancescanwasperformedon18patients.Theresultswerecomparedwithclinicaldiagnosisorsurgicalfindingsandpathologicalexamination.Non-breath-holdthickslicesheavyT2weightedTSEsequencewasused.Theoriginalimageswerereconstructedbyusingthree-dimensionalmaximum-intensity-projection(MIP)algorithm.　Results　TheaccuracyofMRIandMRCPinthedetectionofthedegreeandlevelofbileductobstructionwas100.0%andtheaccuracyforevaluatingthecausesofobstructionwas91.5%.Inthediagnosisofbileductstoneandmalignantbiliaryobstruction,thediagnosticrateofMRCPwas96.8%and86.9%.　Conclusion　RoutineMRIandMRCPexaminationcanaccuratelydefinethelevelofbileductobstruction.Combiningwiththeoriginalimagesandroutineimagesanddynamicenhancescan,thespecificityforthediagnosisofbileductstoneandmalignantbiliaryobstructionishigh.