Macdonald G A, Peduto A J
Department of Medicine, The University of Queensland and The Queensland Institute of Medical Research, Brisbane, Australia.
J Gastroenterol Hepatol. 2000 Sep;15(9):992-9. doi: 10.1046/j.1440-1746.2000.02277.x.
Magnetic resonance cholangiography (MRC) relies on the strong T2 signal from stationary liquids, in this case bile, to generate images. No contrast agents are required, and the failure rate and risk of serious complications is lower than with endoscopic retrograde cholangiopancreatography (ERCP). Data from MRC can be summated to produce an image much like the cholangiogram obtained by using ERCP. In addition, MRC and conventional MRI can provide information about the biliary and other anatomy above and below a biliary obstruction. This provides information for therapeutic intervention that is probably most useful for hilar and intrahepatic biliary obstruction. Magnetic resonance cholangiography appears to be similar to ERCP with respect to sensitivity and specificity in detecting lesions causing biliary obstruction, and in the diagnosis of choledocholithiasis. It is also suited to the assessment of biliary anatomy (including the assessment of surgical bile-duct injuries) and intrahepatic biliary pathology. However, ERCP can be therapeutic as well as diagnostic, and MRC should be limited to situations where intervention is unlikely, where intrahepatic or hilar pathology is suspected, to delineate the biliary anatomy prior to other interventions, or after failed or inadequate ERCP. Magnetic resonance angiography (MRA) relies on the properties of flowing liquids to generate images. It is particularly suited to assessment of the hepatic vasculature and appears as good as conventional angiography. It has been shown to be useful in delineating vascular anatomy prior to liver transplantation or insertion of a transjugular intrahepatic portasystemic shunt. Magnetic resonance angiography may also be useful in predicting subsequent variceal haemorrhage in patients with oesophageal varices.
磁共振胆胰管造影（MRC）依靠静止液体（在此为胆汁）的强T2信号来生成图像。无需使用造影剂，其失败率和严重并发症风险低于内镜逆行胰胆管造影（ERCP）。MRC数据可汇总生成一幅与使用ERCP获得的胆管造影图像非常相似的图像。此外，MRC和传统MRI可提供有关胆管梗阻上下方的胆管及其他解剖结构的信息。这为治疗干预提供了信息，可能对肝门部和肝内胆管梗阻最为有用。在检测引起胆管梗阻的病变及胆总管结石的诊断方面，磁共振胆胰管造影在敏感性和特异性上似乎与ERCP相似。它也适用于胆管解剖结构的评估（包括手术胆管损伤的评估）和肝内胆管病变。然而，ERCP兼具治疗和诊断功能，MRC应限于不太可能进行干预的情况、怀疑有肝内或肝门部病变的情况、在其他干预之前描绘胆管解剖结构的情况，或在ERCP失败或不充分之后。磁共振血管造影（MRA）依靠流动液体的特性来生成图像。它特别适合评估肝血管系统，效果与传统血管造影一样好。已证明它在肝移植或经颈静脉肝内门体分流术置入前描绘血管解剖结构方面很有用。磁共振血管造影在预测食管静脉曲张患者随后的静脉曲张出血方面可能也有用。
