磁共振胰胆管造影对梗阻性黄疸的诊断价值

目的：评价磁共振胆胰管造影（MRCP）对梗阻性黄疸的诊断价值。方法：对67例梗阻性黄疸进行MRCP检查，并与临床诊断或手术和病理结果对照分析。MRCP采用不屏气快速自旋回波（TSE）序列重度T2W扫描，结合呼吸触发及脂肪抑制技术，原始图像以最大信号强度投影（MIP）法进行三维重建。结果：全部67例MRCP检查均一次成功，MRCP对梗阻性黄疸的定位诊断准确率为100％，定性诊断准确率为83．6％，其中MRCP诊断肝外胆管结石和恶性胆管梗阻的准确率分别为95％和65．4％，结论：MRCP检查成功率高，对梗阻性黄疸的定位诊断准确，结合原始图像和常规MRI扫描，对肝外胆管结石和恶性胆管梗阻的定性诊断也有较高的准确性。

Diagnostic Value of MR Cholangiopancreatography in Obstructive Jaundice

Objective To evaluate the clinical value of MR cholangiopancreatography(MRCP) in diagnosis of obstructive jaundice.Methods MRCP was performed in 67 patients with obstructive jaundice.The results of MRCP were compared with clinical diagnosis or surgical findings and pathology.Non breath hold heavy T 2 weighted TSE sequence with respiratory triggering and fat suppression techniques were used.There primitive images were reconstructed by using three dimensional(3D)maximum intensity prejection(MIP)algorthm.Results MRCP examination was succeeded in all 67 patients.The accuracy of MRCP in the detection of the level of obstructive jaundice was 100%.The accuracy for evaluating the causes of obstruction was 83 6%.In diagnosis of extrahepatic bile duct stone and malignant biliary obstruction,the diagnostic rate of MRCP were 95% and 65 4%,respectively.Conclusions MRCP examination has a high successful rate and can accarately define the level of extrahepatic bile duct obstruction.Combination with the primitive images and routine MRI scanning for analysis,the specificity for the diagnosis of extrahepatic bile duct stone and malignant biliary obstrution is also high.MRCP may substitute for dignosis of direct cholangiopancreatography and provide an optimum alternative, especially in the diagnosis of ERCP and PTC are unsuccessful or inadequate.