Wang Cheng-Lin, Ding He-Yu, Dai Yi, Xie Ting-Ting, Li Yong-Bin, Cheng Lin, Wang Bing, Tang Run-Hui, Nie Wei-Xia
Cheng-Lin Wang, Yi Dai, Ting-Ting Xie, Bing Wang, Wei-Xia Nie, Department of Radiology, Peking University Shenzhen Hospital, Shenzhen 518000, Guangdong Province, China.
World J Gastroenterol. 2014 Jun 14;20(22):7005-10. doi: 10.3748/wjg.v20.i22.7005.
To discuss the imaging anatomy about pancreaticobiliary ductal union, occurrence rate of pancreaticobiliary maljunction (PBM) and associated diseases in a Chinese population by using magnetic resonance cholangiopancreatography (MRCP).
Data were collected from 694 patients who underwent MRCP from January 2010 to December 2012. Three hundred and ninety-three patients were male and 301 patients were female. The age range was 16-92 years old and the average age was 51.8 years. The recruitment indication of all cases was patients who had clinical symptoms, such as abdominal pain, jaundice, nausea and vomiting, which thus were clinically suspected as relative pancreaticobiliary diseases. All cases were examined by MRCP using single-shot fast spin-echo sequences. In order to obtain MRCP images, the maximum intensity projection was used.
According to the anatomy of pancreaticobiliary ductal union based on our analysis of MRCP images, all cases were classified into normal type and abnormal type according to the position of pancreaticobiliary ductal union. The abnormal type could be further divided into P-B type, B-P type and the duodenum type. By analyzing the incidence of biliary stone and inflammation, pancreatitis, biliary duct tumors and pancreatic tumors between normal and abnormal types, significant differences existed. The abnormal group was more likely to suffer from pancreaticobiliary diseases. Comparing three different types of PBM that were associated with pancreaticobiliary diseases by using Fisher's method, the result showed that there was no significant difference in the incidence of biliary stones, cholecystitis and pancreatic tumors. The incidence of pancreatitis in B-P type and P-B type was higher than that in duodenum type; the incidence of biliary duct tumor in B-P type was higher than that in P-B type; the incidence of biliary duct tumor in duodenum type was lower than that in P-B type. The incidence of congenital choledochus dilatation in normal type and abnormal type was similar, and there was no significant difference between the two types.
Types of PBM are closely related to the occurrence of pancreaticobiliary diseases. MRCP has important clinical value in the early diagnosis and preventive treatment of pancreaticobiliary diseases.
通过磁共振胰胆管造影（MRCP）探讨中国人群胰胆管汇合的影像解剖、胰胆管合流异常（PBM）发生率及相关疾病。
收集2010年1月至2012年12月行MRCP检查的694例患者资料。男性393例，女性301例。年龄范围16 - 92岁，平均年龄51.8岁。所有病例入选指征为有腹痛、黄疸、恶心、呕吐等临床症状，临床怀疑为相关胰胆疾病的患者。所有病例均采用单次激发快速自旋回波序列行MRCP检查。为获得MRCP图像，采用最大强度投影法。
根据我们对MRCP图像分析的胰胆管汇合解剖，所有病例按胰胆管汇合位置分为正常型和异常型。异常型可进一步分为P - B型、B - P型和十二指肠型。通过分析正常型和异常型之间胆结石、炎症、胰腺炎、胆管肿瘤和胰腺肿瘤的发生率，存在显著差异。异常组更易患胰胆疾病。采用Fisher法比较与胰胆疾病相关的三种不同类型PBM，结果显示胆结石、胆囊炎和胰腺肿瘤的发生率无显著差异。B - P型和P - B型胰腺炎的发生率高于十二指肠型；B - P型胆管肿瘤的发生率高于P - B型；十二指肠型胆管肿瘤的发生率低于P - B型。正常型和异常型先天性胆总管扩张的发生率相似，两者之间无显著差异。
PBM类型与胰胆疾病的发生密切相关。MRCP在胰胆疾病的早期诊断和防治中具有重要临床价值。
