Kinney Timothy P, Punjabi Gopal, Freeman Martin
Division of Gastroenterology, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN 55415, USA.
Nat Clin Pract Gastroenterol Hepatol. 2007 Mar;4(3):148-59. doi: 10.1038/ncpgasthep0760.
This article reviews the role of MRI in the evaluation of benign pancreatic disease. Although MRI and magnetic resonance cholangiopancreatography (MRCP) are most often used to evaluate the liver and bile duct, technical advances such as the use of secretin stimulation also allow for high-quality imaging of the pancreas and pancreatic ductal system. Secretin-stimulated MRCP (S-MRCP) can aid the diagnosis of acute and chronic pancreatitis, and delineate ductal pathology such as benign strictures and duct leaks. There seems to be a role for S-MRCP in the assessment of pancreatic function and (possibly) sphincter of Oddi dysfunction. When endoscopic or surgical therapy is planned, S-MRCP can help to establish a diagnosis as well as offer a 'road map' to guide therapy. S-MRCP is noninvasive and almost entirely without risk to the patient, which gives it a distinct advantage over traditional endoscopic methods of diagnosis for conditions such as pancreas divisum and other ductal pathology. The information provided by S-MRCP, obtained before endoscopic or surgical therapy is attempted, can assist the patient and physician in making a fully informed decision with regard to the risks and probable benefits of any planned intervention.
本文综述了磁共振成像(MRI)在评估胰腺良性疾病中的作用。尽管MRI和磁共振胰胆管造影(MRCP)最常用于评估肝脏和胆管,但诸如使用促胰液素刺激等技术进步也能实现对胰腺及胰管系统的高质量成像。促胰液素刺激磁共振胰胆管造影(S-MRCP)有助于诊断急性和慢性胰腺炎,并描绘导管病变,如良性狭窄和导管渗漏。S-MRCP在评估胰腺功能和(可能的)Oddi括约肌功能障碍方面似乎有一定作用。当计划进行内镜或手术治疗时,S-MRCP有助于确诊并提供“路线图”以指导治疗。S-MRCP是非侵入性的,对患者几乎完全没有风险,这使其在诊断诸如胰腺分裂症和其他导管病变等疾病时,相较于传统内镜诊断方法具有明显优势。在尝试进行内镜或手术治疗之前获得的S-MRCP提供的信息,可帮助患者和医生就是否进行任何计划中的干预措施的风险和可能的益处做出充分知情的决定。