Ishizaki Y, Wakayama T, Okada Y, Kobayashi T
Department of Surgery and Radiology, Tokyo Metropolitan Hiroo General Hospital, Japan.
Am J Gastroenterol. 1993 Dec;88(12):2072-7.
Magnetic resonance (MR) cholangiography is a newly developed adjunctive tool for noninvasive evaluation of patients with obstructive jaundice. We discuss whether MR cholangiography can provide useful information about the biliary tract, compared with other diagnostic modalities.
MR cholangiographies of 20 patients with obstructive jaundice were reviewed to evaluate the site of obstruction, the cause of obstruction, and the degree of stricture.
The precise location of an obstructing lesion and complete display of the dilated biliary tree just proximal to the obstruction were provided in all 20 patients by MR cholangiography the same as in direct cholangiography. MR cholangiography could completely distinguish common duct stones from malignancies, whereas accurate differentiation among the malignancies was impossible. In six patients, MR cholangiography was not able to help in differentiating between high-grade stenosis and complete occlusion.
Although precise cholangiographic estimation of the morphology and extent of the malignant disease by MR cholangiography was inferior to direct cholangiography, MR cholangiography is easily performed for a short duration and is a noninvasive diagnostic modality for assessing the outline of the anatomy of the dilated biliary tree. Therefore, we recommend promptly performing MR cholangiography if obstructive jaundice is suspected on clinical grounds.
磁共振（MR）胆管造影是一种新开发的用于对梗阻性黄疸患者进行无创评估的辅助工具。我们探讨与其他诊断方式相比，MR胆管造影是否能提供有关胆道的有用信息。
回顾了20例梗阻性黄疸患者的MR胆管造影，以评估梗阻部位、梗阻原因和狭窄程度。
20例患者的MR胆管造影均能提供梗阻性病变的精确位置，并完整显示梗阻近端扩张的胆管树，与直接胆管造影相同。MR胆管造影能够完全区分胆总管结石与恶性肿瘤，但无法对恶性肿瘤进行准确鉴别。6例患者中，MR胆管造影无法区分高度狭窄与完全闭塞。
虽然MR胆管造影对恶性疾病形态和范围的精确胆管造影评估不如直接胆管造影，但MR胆管造影操作简便、耗时短，是评估扩张胆管树解剖轮廓的无创诊断方式。因此，我们建议如果基于临床怀疑有梗阻性黄疸，应及时进行MR胆管造影。
