多发性胆管乳头状瘤病：磁共振胆胰管造影与内镜逆行胆胰管造影的比较

Multiple biliary papillomatosis: comparison of MR cholangiography with endoscopic retrograde cholangiography.

作者信息

Chung Dong Jin, Lee Sung Koo, Ha Hyun Kwon, Kim Pyo Nyun, Lee Moon-Gyu

机构信息

Department of Radiology, University of Ulsan-Asan Medical Center, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Korea.

出版信息

J Comput Assist Tomogr. 2002 Nov-Dec;26(6):968-74. doi: 10.1097/00004728-200211000-00020.

DOI:10.1097/00004728-200211000-00020

PMID:12488745

Abstract

PURPOSE

The purpose of this work was to compare MR cholangiography with endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of multiple biliary papillomatosis (MBP).

METHOD

Nine patients with pathologically proven MBP underwent MR cholangiography and ERCP. A comparison was made between ERCP, multislice HASTE, and single-shot RARE. Each biliary tract was divided into five sections for assessment; therefore, 45 biliary duct areas were used for lesion detection and determination of quality of depiction.

RESULTS

Of the 35 segments detected by percutaneous transhepatic cholangioscopy, pathologic examinations were performed in 31 segments: papillary adenocarcinoma was proved in 28 and papillary adenoma in 3. The multislice HASTE sequence showed bile duct branches with biliary papillomatosis better than did ERCP (p = 0.0029) and single-shot RARE sequence (p = 0.0558). The multislice HASTE procedure had the highest number of lesions detected, followed by single-shot RARE and ERCP, but there was no significant difference between the imaging techniques.

CONCLUSION

Our preliminary data suggest that MR cholangiography can replace ERCP for the detection of MBP.

摘要

目的

本研究旨在比较磁共振胰胆管造影（MR cholangiography）与内镜逆行胰胆管造影（ERCP）在诊断多发性胆管乳头状瘤病（MBP）中的应用。

方法

9例经病理证实为MBP的患者接受了MR cholangiography和ERCP检查。对ERCP、多层快速自旋回波（HASTE）序列和单次激发快速自旋回波（RARE）序列进行了比较。将每条胆管分为五个节段进行评估；因此，共45个胆管区域用于病变检测和图像质量判定。

结果

经皮经肝胆道镜检查发现35个节段，其中31个节段进行了病理检查：28个节段证实为乳头状腺癌，3个节段为乳头状腺瘤。多层HASTE序列显示胆管分支合并胆管乳头状瘤病的情况优于ERCP（p = 0.0029）和单次激发RARE序列（p = 0.0558）。多层HASTE序列检测到的病变数量最多，其次是单次激发RARE序列和ERCP，但这些成像技术之间无显著差异。