Sugiyama M, Atomi Y, Hachiya J
The First Department of Surgery, Kyorin University School of Medicine, Mitaka, Tokyo, Japan.
Am J Gastroenterol. 1998 Feb;93(2):156-9. doi: 10.1111/j.1572-0241.1998.00156.x.
We analyzed the findings of intraductal papillary tumors of the pancreas by magnetic resonance cholangiopancreatography (MRCP).
Twelve patients with intraductal papillary tumors (main duct type, n = 3; branch duct type, n = 8; combined type, n = 1) underwent endoscopic retrograde cholangiopancreatography (ERCP) (n = 11) and MRCP, using half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequences (n = 12). Imaging findings were compared with operative and pathological findings in all the patients.
Although ERCP failed to fully depict the main pancreatic duct and cystic tumors in six of 11 patients because of copious intraductal mucin, MRCP provided complete images of these structures in all 12 patients. In main duct type tumors, MRCP demonstrated moderate-marked, diffuse dilation of the main pancreatic duct. Branch duct type tumors showed "grape-like" clusters of cysts with no or only mild, diffuse dilation of the main duct. In combined type tumors, MRCP demonstrated a markedly dilated main duct with a large unilocular cyst of the collateral duct. MRCP detected more mural nodules (75%, three of four patients) than ERCP (25%, one of four). MRCP allowed more precise diagnosis of the type, size, and extent of tumors than ERCP, as confirmed by pathologic findings.
MRCP demonstrates intraductal papillary tumors less invasively and more completely than ERCP.
我们通过磁共振胰胆管造影（MRCP）分析胰腺导管内乳头状肿瘤的检查结果。
12例胰腺导管内乳头状肿瘤患者（主胰管型3例；分支胰管型8例；混合型1例）接受了内镜逆行胰胆管造影（ERCP）（11例）和MRCP检查，采用半傅里叶采集单次激发快速自旋回波（HASTE）序列（12例）。将所有患者的影像学检查结果与手术及病理检查结果进行比较。
11例患者中有6例因导管内大量黏液而导致ERCP未能完整显示主胰管和囊性肿瘤，但MRCP在所有12例患者中均提供了这些结构的完整图像。在主胰管型肿瘤中，MRCP显示主胰管呈中度至明显的弥漫性扩张。分支胰管型肿瘤表现为“葡萄样”囊肿群，主胰管无扩张或仅轻度弥漫性扩张。在混合型肿瘤中，MRCP显示主胰管明显扩张，分支胰管有一个大的单房囊肿。MRCP检测到的壁结节（75%，4例患者中的3例）多于ERCP（25%，4例患者中的1例）。病理结果证实，MRCP比ERCP能更精确地诊断肿瘤的类型、大小和范围。
与ERCP相比，MRCP能以侵入性较小且更完整的方式显示胰腺导管内乳头状肿瘤。
