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目的探讨MRI平扫加增强及联合磁共振胰胆管水超重T_2WI成像在高位胆道恶性梗阻疾病中的诊断价值。方法选取来杞县中医院肝胆外科、肿瘤科及内科等科室进行诊治的高位胆道恶性梗阻疾病患者23例,均采取MRI平扫加增强成像和磁共振胰胆管水超重T_2WI成像联合检查成像方式进行检查,分析在高位胆道恶性梗阻疾病诊断中的临床价值。结果23例患者经MRI平扫或增强检查方式和磁共振胰胆水超重T2W I成像方式相结合检查,胆道系统均能良好显示,左右肝管均能全部显示,胆囊部分显示,肝总管、胆总管均能良好显示。23例患者中,15例梗阻以上胆道重度度扩张,8例梗阻以上胆道轻度扩张。23例患者中,5例为肝门梗阻,其中左肝管梗阻2例,右肝管梗阻3例;13例为胆总管末端梗阻。高位胆道恶性梗阻疾病的临床诊断准确率为95%(22/23),其中1例胆管炎伴随小结石患者被误诊为壶腹癌。结论磁共振胰胆管重T2W I水成像检查提供的是胆道系统内部的病变,而M RI平扫及加增强检查则能够很好地提供患者胆道系统外的病变信息,两者联合使用能显著提高高位胆道恶性梗阻疾病的临床诊断准确率。
Objective To investigate the diagnostic value of MRI scan and contrast enhancement combined with magnetic resonance cholangiopancreatography overweight T2WI imaging in patients with malignant biliary obstruction. Methods Twenty-three patients with malignant biliary obstruction who were diagnosed and treated in Department of Hepatobiliary Surgery, Oncology and Internal Medicine in Qixian Hospital of Traditional Chinese Medicine were examined by MRI and contrast-enhanced magnetic resonance cholangiopancreatography (T2WI) Check, analyze the clinical value of diagnosis of high biliary malignant obstruction. Results Twenty-three patients underwent MR plain scan or enhanced MRI scan combined with MR T2W I imaging. The biliary system was well demonstrated, both of the left and right hepatic duct could be fully displayed, the gallbladder part showed that the common hepatic duct Explorer can be a good show. Of the 23 patients, 15 had a biliary severe degree of dilatation over the obstruction, and 8 had a mild dilatation of the biliary tract above the obstruction. Among the 23 patients, hepatic portal obstruction was found in 5 cases, including 2 cases of left hepatic duct obstruction and 3 cases of right hepatic duct obstruction. Thirteen cases were common bile duct obstruction. The clinical diagnosis accuracy of high biliary malignant obstruction was 95% (22/23), of which 1 case of cholangitis accompanied by small calculus was misdiagnosed as ampulla. Conclusions The magnetic resonance cholangiopancreatography T2WI water imaging provides the internal lesion of the biliary tract. However, M RI scan combined with enhanced MRI can provide good information about the lesions outside the biliary tract of patients, and the combined use of the two can significantly improve High diagnostic accuracy of biliary malignant obstruction disease.