中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2014年
z2期
20-22
,共3页
磁共振胰胆管造影%经内镜逆行胰胆管造影%胆道梗阻
磁共振胰膽管造影%經內鏡逆行胰膽管造影%膽道梗阻
자공진이담관조영%경내경역행이담관조영%담도경조
Magnetic resonance cholangiopancreatography%Gadoxetate acid%Biliary obstruction
目的：探讨磁共振胰胆管成像（magnetic resonance cholangiopancreatography ，MRCP）和钆塞酸二钠（gadoxetate acid，Gd－EOB－DTPA）增强磁共振（magnetic resonance，MR）诊断梗阻性黄疸的价值，为临床提供诊断依据。方法回顾性分析本院138例胆道梗阻患者的影像学资料。入选患者均先后完成了 MRCP 和 Gd－EOB－DTPA 增强 MR 检查，并最终经手术病理确诊，比较两种方法应用于胆道梗阻的诊断价值。结果本研究中138例患者 MRCP 和 Gd－EOB－DTPA 增强扫描均获得成功， MRCP 和 Gd－EOB－DTPA 增强两者诊断一致的患者86例，不一致者52例，诊断一致率为62．3％。在诊断一致的患者中，病因包括：胆总管结石58例，胆总管占位7例，壶腹部占位3例，胆总管狭窄3例，胰头癌4例，慢性胰腺炎3例，未见异常者8例。诊断不一致的52例患者中，MRCP 诊断为恶性病变18例，良性病变23例，未见异常者11例；Gd－EOB－DTPA 增强胆管成像诊断为恶性病变22例，良性病变26例，未见异常者4例。结论MRCP 对诊断胆总管扩张的敏感度、准确性较高，但对扩张的病因学诊断有限，且对胆总管较小结石的诊断方面不如 Gd－EOB－DTPA 增强胆管成像敏感及准确。
目的：探討磁共振胰膽管成像（magnetic resonance cholangiopancreatography ，MRCP）和釓塞痠二鈉（gadoxetate acid，Gd－EOB－DTPA）增彊磁共振（magnetic resonance，MR）診斷梗阻性黃疸的價值，為臨床提供診斷依據。方法迴顧性分析本院138例膽道梗阻患者的影像學資料。入選患者均先後完成瞭 MRCP 和 Gd－EOB－DTPA 增彊 MR 檢查，併最終經手術病理確診，比較兩種方法應用于膽道梗阻的診斷價值。結果本研究中138例患者 MRCP 和 Gd－EOB－DTPA 增彊掃描均穫得成功， MRCP 和 Gd－EOB－DTPA 增彊兩者診斷一緻的患者86例，不一緻者52例，診斷一緻率為62．3％。在診斷一緻的患者中，病因包括：膽總管結石58例，膽總管佔位7例，壺腹部佔位3例，膽總管狹窄3例，胰頭癌4例，慢性胰腺炎3例，未見異常者8例。診斷不一緻的52例患者中，MRCP 診斷為噁性病變18例，良性病變23例，未見異常者11例；Gd－EOB－DTPA 增彊膽管成像診斷為噁性病變22例，良性病變26例，未見異常者4例。結論MRCP 對診斷膽總管擴張的敏感度、準確性較高，但對擴張的病因學診斷有限，且對膽總管較小結石的診斷方麵不如 Gd－EOB－DTPA 增彊膽管成像敏感及準確。
목적：탐토자공진이담관성상（magnetic resonance cholangiopancreatography ，MRCP）화구새산이납（gadoxetate acid，Gd－EOB－DTPA）증강자공진（magnetic resonance，MR）진단경조성황달적개치，위림상제공진단의거。방법회고성분석본원138례담도경조환자적영상학자료。입선환자균선후완성료 MRCP 화 Gd－EOB－DTPA 증강 MR 검사，병최종경수술병리학진，비교량충방법응용우담도경조적진단개치。결과본연구중138례환자 MRCP 화 Gd－EOB－DTPA 증강소묘균획득성공， MRCP 화 Gd－EOB－DTPA 증강량자진단일치적환자86례，불일치자52례，진단일치솔위62．3％。재진단일치적환자중，병인포괄：담총관결석58례，담총관점위7례，호복부점위3례，담총관협착3례，이두암4례，만성이선염3례，미견이상자8례。진단불일치적52례환자중，MRCP 진단위악성병변18례，량성병변23례，미견이상자11례；Gd－EOB－DTPA 증강담관성상진단위악성병변22례，량성병변26례，미견이상자4례。결론MRCP 대진단담총관확장적민감도、준학성교고，단대확장적병인학진단유한，차대담총관교소결석적진단방면불여 Gd－EOB－DTPA 증강담관성상민감급준학。
Objective To evaluate the diagnostic value of MRCP and Gd -EOB-DTPA-enhanced MR for biliary obstruction dis -ease, and provide basis to choose the suitable method for this patient .Methods A respectively analysis was carried out from 2011 to 2013in 138 biliary obstruction cases.All the cases had undergone both MRCP and Gd -EOB-DTPA-enhanced MR examinations and fi -nally proven by pathology .A comparison was made in these two methods .Results All the 138 cases by MRCP and Gd-EOB-DTPA-enhanced MR were successful.The same diagnosis based on MRCP and Gd -EOB-DTPA-enhanced MR was 86 cases (62.3%).The different diagnosis was 52 cases.In the 52 different cases, MRCP was tumor, Gd-EOB-DTPA-enhanced MR was stone and MRCP was stone, Gd-EOB-DTPA-enhanced MR was normal.Conclusions MRCP is a noninvasive diagnostic modality capable of producing high quality imagines of bile duct and pancreatic tract .It has a high sensitivity and specificity in the evaluation of the bile duct and pancreatic tract.The efficacy of Gd-EOB-DTPA-enhanced MR is sufficient to justify its use in the diagnosis of bile duct and pancreatic tract diseases.Gd-EOB-DTPA-enhanced MR has a similar diagnosis effectiveness in bile duct obstruction .
