Irie H, Honda H, Kuroiwa T, Yoshimitsu K, Aibe H, Shinozaki K, Masuda K
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Radiographics. 2001 Jan-Feb;21(1):23-37. doi: 10.1148/radiographics.21.1.g01ja0523.
Magnetic resonance (MR) cholangiopancreatography (MRCP) is widely used in the evaluation of pancreatobiliary disorders. However, numerous related pitfalls may simulate or mask pancreatobiliary disease. Maximum-intensity-projection (MIP) reconstructed images completely obscure small filling defects and may demonstrate respiratory motion artifacts. T2 weighting may vary with different MR imaging sequences and influence MRCP findings. Incomplete imaging may create confusion regarding ductal anatomy or disease. Furthermore, MRCP yields only static images and thus may fail to depict various anomalies. Limited spatial resolution makes differentiation between benign and malignant strictures with MRCP alone extremely difficult. Susceptibility artifacts may be caused by metallic foreign bodies or gastric-duodenal gas. Fluid accumulation may produce a pseudolesion or pseudostricture, although changing the imaging angle or section thickness may be helpful. Pneumobilia may be misinterpreted as bile duct stones, and true stones may be overlooked. Pulsatile vascular compression can cause pseudo-obstruction of the bile duct. Use of both source and MIP reconstructed images obtained from different angles can help avoid cystic duct-related pitfalls. Repeat MRCP or conventional MR imaging can help avoid pitfalls related to the periampullary region. Segmental collapse of the normal main pancreatic duct may be misinterpreted as stenosis, but administration of secretin is helpful. An awareness of these pitfalls and possible solutions is crucial for avoiding misinterpretation of MRCP images.
磁共振胰胆管造影（MRCP）广泛应用于胰腺胆管疾病的评估。然而，许多相关的陷阱可能会模拟或掩盖胰腺胆管疾病。最大强度投影（MIP）重建图像会完全掩盖小的充盈缺损，并可能显示呼吸运动伪影。T2加权可能因不同的磁共振成像序列而有所不同，并影响MRCP的结果。成像不完整可能会导致对胆管解剖结构或疾病的混淆。此外，MRCP仅产生静态图像，因此可能无法描绘各种异常情况。有限的空间分辨率使得仅通过MRCP区分良性和恶性狭窄极其困难。金属异物或胃十二指肠气体可能会导致磁敏感伪影。液体聚集可能会产生假病变或假狭窄，不过改变成像角度或层面厚度可能会有所帮助。胆道积气可能会被误诊为胆管结石，而真正的结石可能会被忽略。搏动性血管压迫可导致胆管假性梗阻。使用从不同角度获得的原始图像和MIP重建图像有助于避免与胆囊管相关的陷阱。重复进行MRCP或传统的磁共振成像有助于避免与壶腹周围区域相关的陷阱。正常主胰管的节段性塌陷可能会被误诊为狭窄，但注射促胰液素会有所帮助。了解这些陷阱和可能的解决方法对于避免MRCP图像的误读至关重要。
