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1、·094·实用医学影像杂志2010年第11卷第2期JPMI，2010，Vol.11,No.2·论著·磁共振胰胆管成像在胰胆管疾病诊断中的应用价值刘继华（天津中医药大学第一附属医院放射科，天津300193）【摘要】目的探讨磁共振胰胆管成像（MRCP）在胰胆管疾病诊断中的临床应用价值。方法采用重T2加权多次激发对100例临床拟诊胆道梗阻的患者进行MRCP检查，并经手术病理或其他影像学或临床资料证实。恶性梗阻28例，其中胰头癌9例，壶腹癌6例，胆管癌10例，原发性肝细胞癌直接侵犯3例；良性梗阻72例，其中胆
2、总管结石33例，胆囊切除术后狭窄5例，胆囊炎或结石26例，慢性胰腺炎4例，先天性胆总管囊肿2例，硬化性胆管炎2例。结果MRCP较清晰地显示了各种胰胆管疾病的部位和形态。本组定位诊断准确率为85%。MRCP的诊断敏感性为75%，特异性为83%,准确性为81%，阳性预测值为85%，阴性预测值为93%。结论MRCP对于胆道梗阻性病变的定位较为准确，结合MRI平扫及资源像，定性诊断也有一定的特异性，是一种安全、无创的检查手段，能为临床诊治提供可靠依据。【关键词】胰胆管疾病；磁共振胰胆管成像；病理；鉴别诊断【中
3、图分类号】R445.2;R575.7【文献标识码】A【文章编号】1009-6817（2010）02-0094-04ClinicalapplicationofMRCPinthediagnosisofpancreaticobiliaryductdiseasesLiuJihua.DepartmentofRadiology,FirstAffiliatedHospitalofTianjinTraditionalChineseMedicine,Tianjin300193,China【Abstract】Object
4、iveToevaluatethediagnosticvalueofmagneticresonancecholangiopancreatography(MRCP)indetermingthelo－cationandnatureofpancreaticobiliaryductdiseases(PBDDs).MethodsAhundredpatientswithsurgicallyandpathologicallyorclinicallyprovedPBDDswhichcomprised28casesofm
5、alignantlesions(9pancreaticheadcarcinomas,6ampullarycarcinomas,10bileductcarci－nomas,3primaryhepatocellularcarcinomas)and72casesofbenignlesions(33choledocholithiasis,5postoperativegallbladderstricture,26cholecystitisorcholelithiasis,4chronicpancreatitis
6、,2congenitalcholedochocystand2scleroticcholangitis)underwentMRCPexamina－tions.TheprocedurewasperformedbyusingheavilyT2weightedHASTEsequence.ResultsMRCPcouldclearlyvisualizethesiteandshapeofPBDDlesions.ThelocalizedaccuracyofMRCPforPBDDlesionswas85%.These
7、nsitivity,specificity,accuracy,positivepredic－tivevalue,andnegativepredictivevalueofMRCPinthegrouppatientswere75%,83.3%,81%,84.8%,and93%,respectively.Conclu－sionMRCPhashigheraccuracyinthelocalizeddiagnosisofPBDDs,whileitscombinationwithconventionalMRIan
8、dresourceimageshashigherspecificityforthequalitativediagnosis,simultaneously,itisasafeandnon-invasivemodalitywhichcanprovidethereliableevi－denceforclinicaldiagnosisandtreatment.【Keywords】Pancreaticobiliaryductdisease;MRCP;Patholo
