三维磁共振胰胆管成像诊断婴儿胆道闭锁.pdf
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三维磁共振胰胆管成像诊断婴儿胆道闭锁.pdf

三维磁共振胰胆管成像诊断婴儿胆道闭锁.pdf

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中国医学影像技术2010年第26卷第9期ChinJMedImagingTechnol,2010,Vol26,No9#1725#腹部影像学Three-dimensionalmagneticresonancecholangiopancreatographyinthediagnosisofbiliaryatresiaininfantsLIUBo,XUYe*,PENGXue-hua,YANGJing,RANQi-ying(DepartmentofRadiology,Children'sHospitalofChongqingMedicalUniversity,Chongqing400014,China)[Abstract]ObjectiveToanalyzethediagnosticvalueofthree-dimensionalmagneticresonancecholangiopancreatography(3D-MRCP)forbiliaryatresia(BA)ininfants.MethodsThirteenpatientswithclinicalsuspicionofBAunderwent3D-MRCP.Theyalsounderwentintraoperativecholangiography,laparoscopicexplorationorpathologicalexaminationaccordingtotheMRImanifestations.Thecoincidenceofthefindingsof3D-MRCPwithintraoperativecholangiography,laparoscopyandpathologywerecomparedandanalyzed.ResultsMRIdiagnosedBAin10patients,choledochalcystin2andnormalnessin1patient.Withintraoperativecholangiography,BAwasdiagnosedin6patients,biliarystricturein1andnormalnessin1patient.Withlaparoscopy,2patientswerediagnosedasBA.Twopatientswerediagnosedascongenitalcholedochalcystwithsurgeryandpathology.Theotheronecuredafternon-operativetreatment.Conclusion3D-MRCPisaneffectiveima-gingtechnologyinfindingBAbeforeoperation.BAshouldbehighlysuspectedifextrahepaticbileductcannotbeobservedwith3D-MRCP.[Keywords]Cholangiopancreatography,magneticresonance;Biliaryatresia;Infant三维磁共振胰胆管成像诊断婴儿胆道闭锁刘波,徐晔*,彭雪华,杨静,冉启英(重庆医科大学附属儿童医院放射科,重庆400014)[摘要]目的分析3D-MRCP对婴幼儿胆道闭锁的诊断价值。方法收集13例临床怀疑为胆道闭锁的患儿,所有患儿均接受3D-MRCP检查,根据MRI诊断结果,选择术中造影、腹腔镜探查或病理检查。对比分析所有患儿的3D-MRCP与术中造影、腹腔镜探查及手术病理所见。结果MRI诊断胆道闭锁10例,胆总管囊肿2例,1例正常;术中造影诊断胆道闭锁6例、胆道狭窄1例,显影正常1例;腹腔镜诊断胆道闭锁2例;手术病理诊断为先天性胆总管囊肿2例;另有1例患儿经临床治疗后痊愈。结论3D-MRCP可在术前有效诊断BA。如经3D-MRCP多方位观察,仍未发现完整的肝外胆道,应高度怀疑胆道闭锁。[关键词]胰胆管造影,磁共振;胆道闭锁;婴儿[中图分类号]R72517;R44512[文献标识码]A[文章编号]1003-3289(2010)09-1725-03胆道闭锁(biliaryatresia,BA)指肝外胆管部分或全部发儿肝炎综合征(neonatehepatitis,NH)相鉴别。本研究对13生闭锁,为发生于新生儿及婴儿期的少见畸形,是引起新生儿例临床怀疑为BA的患儿行常规MRI及三维磁共振胰胆管和婴幼儿黄疸的常见原因之一。BA是危及患儿生命的严重成像(three-dimensionalmagneticresonancecholangiopancre-疾患,必须尽早手术