Pavone P, Laghi A, Catalano C, Broglia L, Fiocca F, Passariello R
Istituto di Radiologia, II Cattedra, Università degli Studi di Roma La Sapienza, Italy.
Ital J Gastroenterol. 1996 Feb-Mar;28(2):63-9.
Magnetic resonance cholangiopancreatography is a new, non-invasive imaging technique for visualization of the biliary ducts. Magnetic resonance cholangiopancreatography was performed on 136 patients (20-87 years old) with a superconductive magnet at 0.5T (Philips Gyroscan T5). Volumetric images on coronal planes were acquired; a T2 weighted turbo spin echo sequence (TR = 3000; TE = 700; number of excitations = 8; echo train length = 128; Acquisition time = 5'48") with respiratory compensation was performed. Images were reconstructed on coronal planes rotated at different angles using the MIP algorithm. When neoplastic disease was detected additional images on axial planes (SE Tlw: TR/TE 300/10 and turbo spin echo T2w: TR/TE 3000/120) were acquired. Magnetic resonance cholangiopancreatography allowed images of diagnostic value to be obtained in all cases. In choledocholithiasis, the technique had a sensitivity of 91.6%, specificity of 100% and overall diagnostic accuracy of 96.8%. Of the 48 patients with stenotic lesions, 16 cases were correctly characterized as benign and 30 as malignant. Two cases of focal chronic pancreatitis were misdiagnosed as pancreatic head carcinoma. In patients submitted to bilioenteric anastomosis, the technique was able to detect dilation of intrahepatic ducts, stenosis and associated stones in the 8 positive cases. In all 11 patients with chronic pancreatitis, dilated Wirsung duct and the stenotic tracts were revealed. In conclusion, magnetic resonance cholangiopancreatography can be considered as a technique able to completely replace diagnostic endoscopic retrograde cholangiopancreatography. However, further studies are necessary for a better evaluation of potential advantage and disadvantages.
磁共振胰胆管造影是一种用于可视化胆管的新型非侵入性成像技术。对136例年龄在20至87岁之间的患者使用0.5T超导磁体（飞利浦Gyroscan T5）进行磁共振胰胆管造影。采集冠状面的容积图像；采用呼吸补偿的T2加权快速自旋回波序列（TR = 3000；TE = 700；激励次数 = 8；回波链长度 = 128；采集时间 = 5分48秒）。使用MIP算法在不同角度旋转的冠状面上重建图像。当检测到肿瘤性疾病时，还采集轴面的额外图像（SE T1w：TR/TE 300/10和快速自旋回波T2w：TR/TE 3000/120）。磁共振胰胆管造影在所有病例中均获得了具有诊断价值的图像。在胆总管结石病例中，该技术的敏感性为91.6%，特异性为100%，总体诊断准确性为96.8%。在48例有狭窄病变的患者中，16例被正确判定为良性，30例为恶性。2例局灶性慢性胰腺炎被误诊为胰头癌。在接受胆肠吻合术的患者中，该技术在8例阳性病例中能够检测到肝内胆管扩张、狭窄及相关结石。在所有11例慢性胰腺炎患者中，均显示了扩张的胰管和狭窄段。总之，磁共振胰胆管造影可被视为一种能够完全替代诊断性内镜逆行胰胆管造影的技术。然而，需要进一步研究以更好地评估其潜在的优缺点。
