| 侯新萌,靳二虎,张洁,牛应林,苏天昊,梁宇霆,贺文.原发性硬化性胆管炎的磁共振胰胆管成像表现[J].中国医学影像技术,2013,29(10):1670~1673 |
| 原发性硬化性胆管炎的磁共振胰胆管成像表现 |
| Magnetic resonance cholangiopancreatographic features of primary sclerosing cholangitis |
| 投稿时间：2013-02-05 修订日期：2013-03-19 |
| DOI： |
| 中文关键词: 胆管炎 硬化性 胰胆管造影术,磁共振 胆管 |
| 英文关键词:Cholangitis sclerosing Cholangiopancreatography,magnetic resonance Bile ducts |
| 基金项目: |
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| 中文摘要: |
| 目的 分析原发性硬化性胆管炎(PSC)的磁共振胰胆管成像(MRCP)表现.方法 回顾性分析确诊为PSC的18例患者(PSC组)的临床及影像学资料,另选取20名健康志愿者作为对照组.结果 PSC组中,肝内外混合型9例(9/18,50.00%),单纯肝内型6例(6/18,33.33%),单纯肝外型3例(3/18,16.67%).MRCP表现:5例(5/18,27.78%)胆管串珠样改变,5例(5/18,27.78%)胆管呈剪枝征,8例(8/18,44.44%)肝内4级以上胆管显示,4例(4/18,22.22%)周围肝内胆管抵达肝脏边缘.18例PSC胆总管及肝总管均无扩张;2例(2/18,11.11%)肝内Ⅰ级胆管中度扩张;12例(12/18,66.67%)肝内Ⅱ级及以上胆管扩张,其中轻度扩张9例,中度扩张1例,重度扩张2例;15例(15/18,83.33%)扩张的周围肝内胆管直径大于中央肝内胆管直径.与对照组比较,PSC组肝总管直径较小,肝内Ⅱ级及Ⅱ级以上胆管直径明显增大(t分别为-3.245、5.068;P分别为0.003、<0.001),胆总管、左肝管及右肝管直径两组差异无统计学意义(P分别为0.128、0.721、0.759).结论 MRCP可显示胆管形态特征, 初步诊断PSC,有很好的临床应用价值. |
| 英文摘要: |
| Objective To investigate the features of primary sclerosing cholangitis (PSC) on magnetic resonance cholangiopancreatography (MRCP). Methods Clinical and imaging data of 18 PSC patients (PSC group) were retrospectively analyzed, and 20 healthy volunteers were selected as control group. Results There were 9 (9/18, 50.00%) of intrahepatic and extrahepatic bile duct mixed type PSC, 6 (6/18, 33.33%) of intrahepatic bile duct type and 3 (3/18, 16.67%) of extrahepatic bile duct type PSC. On MRCP, 5 cases manifested as beaded bile ducts (5/18, 27.78%) and 5 manifested as pruning signs (5/18, 27.78%), while intrahepatic bile ducts above grade 4 were displayed in 8 cases (8/18, 44.44%) and peripheral intrahepatic bile ducts reached the liver edge in 4 cases (4/18, 22.22%). There was no dilatation of common bile duct, nor of common hepatic duct.Ⅰgrade intrahepatic bile ducts were found moderately dilated in 2 cases (2/18, 11.11%), and Ⅱ and above Ⅱ grade intrahepatic bile duct dilation were observed in 12 cases (12/18, 66.67%), mild in 9, moderate in 1 and severe in 2 cases. The diameters of peripheral intrahepatic bile ducts were greater than central intrahepatic bile ducts in 15 cases (15/18, 83.33%). Compared with control group, the maximum diameters of common hepatic ducts as well as Ⅱ and above Ⅱ grade intrahepatic bile ducts in PSC patients were statistically greater (t=-3.245, 5.068; P=0.003, <0.001), while there was no statistical difference in the maximum diameter of common bile ducts, left and right hepatic ducts between the two groups (P=0.128, 0.721, 0.759). Conclusion MRCP can display morphological characteristics of bile ducts and make preliminary diagnosis for PSC, therefore having great value in clinical application. |
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