Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University, College of Medicine, 250 Seongsanno (134 Sinchon-dong), Seodaemungu, Seoul, 120-752, Korea.
Pediatr Radiol. 2010 May;40(5):687-92. doi: 10.1007/s00247-009-1447-7. Epub 2010 Jan 15.
Spontaneous bile duct perforation (SBP) is rare in children. Early diagnosis is important because the condition can be treated surgically.
The purpose of this study is to report MR cholangiopancreatography (MRCP) findings of SBP and to evaluate the usefulness of MRCP.
Over the last 10 years, three children (1 boy, 2 girls; ages 3, 4 and 15 months) underwent US, MRCP and hepatobiliary scintigraphy preoperatively and were surgically confirmed to have extrahepatic bile duct perforation.
US showed ascites in all children and a choledochal cyst in one. On MRCP, a moderate-to-large volume of ascites was seen in addition to a loculated fluid collection at the porta hepatis. MRCP also depicted the low insertion of the cystic duct and choledochal cyst in each case. Hepatobiliary scintigraphy showed bile leak from the region of the porta hepatis extending to the whole abdomen. According to the surgical findings, the perforation site was around the junction of the cystic duct and the common hepatic duct in all children.
In children with SBP, MRCP can depict the loculated fluid collection adjacent to the perforation site and associated bile duct anomalies.
自发性胆管穿孔（SBP）在儿童中较为罕见。早期诊断很重要，因为这种情况可以通过手术治疗。
本研究旨在报告 SBP 的磁共振胆胰管成像（MRCP）表现，并评估 MRCP 的有用性。
在过去的 10 年中，3 名儿童（1 男 2 女；年龄 3、4 和 15 个月）接受了术前超声、MRCP 和肝胆闪烁显像，并经手术证实存在肝外胆管穿孔。
超声在所有儿童中均显示腹水，1 例显示胆总管囊肿。MRCP 显示除了肝门区局限性积液外，还存在中到大量腹水。MRCP 还显示了每个病例中胆囊管和胆总管囊肿的低位插入。肝胆闪烁显像显示胆汁从肝门区漏出，延伸至整个腹部。根据手术发现，所有儿童的穿孔部位均在胆囊管和肝总管交界处周围。
在 SBP 患儿中，MRCP 可以显示穿孔部位附近的局限性积液和相关胆管异常。
