Stroszczynski C, Hunerbein M
Radiology Charité Campus Virchow, Medical Faculty, Humboldt University, Augustenburger Platz 1, 13353 Berlin, Germany.
Abdom Imaging. 2005 May-Jun;30(3):314-23. doi: 10.1007/s00261-004-0251-y.
This review focuses on the clinical impact of different modalities to image primary and secondary malignant biliary obstruction. The detection and staging of cancers of the pancreatic and biliary tract are best accomplished with endoscopic ultrasound, contrast-enhanced computed tomography, and magnetic resonance cholangiopancreatography. Three-dimensional ultrasound is a new noninvasive method that may be used increasingly as an initial test to select patients who require further diagnostic evaluation by magnetic resonance cholangiopancreatography or therapeutic endoscopic retrograde cholangiopancreatography. All-in-one computed tomography including three-dimensional reconstructions of the biliary tree may be competitive against all-in-one magnetic resonance imaging for diagnosis and staging of pancreatic tumors. Magnetic resonance cholangiopancreatography is excellent for identifying the presence and the level of biliary obstruction. With newer diagnostic imaging technologies emerging, endoscopic retrograde cholangiopancreatography is evolving into a predominantly therapeutic procedure.
本综述聚焦于不同影像学检查方式对原发性和继发性恶性胆道梗阻成像的临床影响。胰腺和胆道癌的检测与分期最佳通过内镜超声、对比增强计算机断层扫描以及磁共振胰胆管造影来完成。三维超声是一种新的无创方法，作为初始检查手段，可能会越来越多地用于筛选那些需要通过磁共振胰胆管造影或治疗性内镜逆行胰胆管造影进行进一步诊断评估的患者。包括胆道树三维重建的一体化计算机断层扫描在胰腺肿瘤的诊断和分期方面可能与一体化磁共振成像相媲美。磁共振胰胆管造影在识别胆道梗阻的存在及梗阻部位方面表现出色。随着更新的诊断成像技术不断涌现，内镜逆行胰胆管造影正逐渐演变为一种以治疗为主的操作。
