Fulcher A S, Turner M A, Capps G W, Zfass A M, Baker K M
Department of Radiology, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0615, USA.
Radiology. 1998 Apr;207(1):21-32. doi: 10.1148/radiology.207.1.9530295.
To determine prospectively the clinical applications and diagnostic accuracy of half-Fourier rapid acquisition with relaxation enhancement (RARE) magnetic resonance (MR) cholangiopancreatography (MRCP) in a large patient population.
Breath-hold, heavily T2-weighted half-Fourier RARE MRCP was performed in 265 patients with suspected pancreaticobiliary disease and in 35 control patients without symptoms or signs referrable to the biliary tract or pancreatic duct. MRCP findings were correlated with those at direct cholangiography, pathologic examination, cross-sectional imaging, and clinical follow-up.
Diagnostic MRCP examinations were obtained in 299 (99.7%) subjects. MRCP yielded an accuracy of 100% in determining the presence of pancreaticobiliary disease, the presence and level of biliary obstruction, and obstruction due to bile duct calculi. The accuracy of MRCP and MR imaging in determining the presence and level of malignant obstruction was 98.2%. MRCP obviated endoscopic retrograde cholangiopancreatography (ERCP) by excluding choledocholithiasis in patients with acute pancreatitis (n = 13) and nonspecific abdominal pain (n = 82). In patients with sclerosing cholangitis and acquired immunodeficiency syndrome cholangiopathy, MRCP depicted the biliary tract as clearly as did ERCP (n = 9). After failed ERCP, MRCP delineated the pancreaticobiliary tract and helped determine therapeutic options (n = 27).
Half-Fourier RARE MRCP enables accurate evaluation of pancreaticobiliary disease and obviates ERCP in some patients.
前瞻性地确定半傅里叶采集单次激发快速自旋回波（RARE）磁共振（MR）胰胆管造影（MRCP）在大量患者中的临床应用及诊断准确性。
对265例疑似胰胆疾病患者及35例无胆道或胰管症状及体征的对照患者进行屏气、重T2加权半傅里叶RARE MRCP检查。将MRCP检查结果与直接胆管造影、病理检查、横断面成像及临床随访结果进行对比。
299例（99.7%）受试者完成了诊断性MRCP检查。MRCP在确定胰胆疾病的存在、胆道梗阻的存在及部位以及胆管结石所致梗阻方面的准确率为100%。MRCP和MR成像在确定恶性梗阻的存在及部位方面的准确率为98.2%。MRCP通过排除急性胰腺炎患者（n = 13）和非特异性腹痛患者（n = 82）的胆总管结石，避免了内镜逆行胰胆管造影（ERCP）。在硬化性胆管炎和获得性免疫缺陷综合征胆管病患者中，MRCP显示胆道的清晰度与ERCP相同（n = 9）。ERCP失败后，MRCP描绘了胰胆管并有助于确定治疗方案（n = 27）。
半傅里叶RARE MRCP能够准确评估胰胆疾病，且在部分患者中可避免进行ERCP。
