MRCP与ERCP对胆道梗阻诊断价值的比较

目的：探讨磁共振胰胆管成像(MRCP)对胰胆管梗阻性疾病的诊断价值及局限性.方法:采用快速自旋回波水成像技术,对35例临床拟诊胆道梗阻并均行内窥镜逆行胰胆管造影(ERCP)的患者进行MRCP检查,并将MRCP影像资料与ERCP进行对照分析,21例经手术病理证实,14例为ERCP检查证实.结果:MRCP成功率为100%,MRCP图像与ERCP极其相似,依据MRCP图像可以作出与ERCP基本一致的诊断.对胆道梗阻的部位诊断正确率达91.4%,定性诊断正确率达80.6%.MRCP图像的空间分辨率略逊于ERCP,有时不能显示胰管及其分支.对ERCP失败或显示不全的病例,MRCP可获得有价值的诊断信息.结论:MR-CP在诊断胆道梗阻性疾病方面具有简便、安全,无创伤性,无需造影剂等优点,而且具有与ERCP相同的诊断价值,在许多方面可取代ERCP.

A comparative study in diagnosis of biliary obstruction with MR cholangiopancreatography and endoscopic retro-

Objective:To detect the diagnostic values and limitations of pancreatobiliary obstructive disease with MRCP.Methods:MRCP using fast echo hydrography was conducted in thirty five patients who were suspected to have pancreatobiliary obstruction and would have all ERCP. The MRCP films was compared with the ERCP. Twenty one of them were confirmed by pathology and operation; fourteen of them were confirmed by ERCP.Results:All MRCP were successful, and the images of MRCP were similar to those of ERCP. The same diagnosis was made based on MRCP images. The diagnostic accuracy of MRCP in the biliary obstructive position was 91.4%; the qualitative diagnostic accuracy was 80.6%. The spacial resolution was slightly inferior to that of ERCP. Sometimes some second grade ducts were not visible. More information was available by MRCP in the patients with unsuccessful or inadequate ERCP.Conclusion:MRCP is not only simple and safe, noninvasive and contrust material is not required in the evaluation of the pancreatobiliary obstructive disease but also offers an equal diagnostic value to ERCP. It can replace ERCP in many fields.