Ueno E, Takada Y, Yoshida I, Toda J, Sugiura T, Toki F
Department of Radiology, Institute of Gastroenterology, Tokyo Women's Medical College, Japan.
Pancreas. 1998 Apr;16(3):418-26.
Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive diagnostic modality capable of producing high-quality images of the biliary tree and pancreatic duct. We evaluated the MRCP capability of depicting the normal pancreatic duct and, based on data achieved, studied the usefulness in the pathologic pancreatic duct. MRCP was performed in 42 patients without any pancreatic lesion and in 162 patients with pancreatic diseases, including congenital anomalies of biliary tree and pancreatic duct. Results were compared with endoscopic retrograde cholangiopancreatography (ERCP) in 93 patients. The visualization of the pancreatic duct and its branches and the presence or absence of dilatation, stenosis, and filling defects were recorded. All images were interpreted retrospectively and blindly by three radiologists. Among control patients, the main pancreatic duct (MPD) was depicted in the head, body, and tail of the pancreas in 41 (98%), 39 (93%), and 31 (74%), and accessory pancreatic duct and secondary branches in the head, body, and tail of the pancreas were depicted in 11 (26%), eight (19%), four (10%), and two (5%) of these patients. Compared with ERCP, MRCP overestimated the stenosis of MPD and underestimated the dilatation of the branches and filling defects in the pancreatic duct in pancreatic diseases, especially pancreatitis. However, MRCP was distinctly advantageous over ERCP in diagnosing mucin-producing tumor of the pancreas, cystic lesions, and depicting the whole, including the part distal to the obstructed site. Four of the eight cases of pancreas divisum, and 10 of the 12 cases of anomalous pancreaticobiliary duct union also were demonstrated. MRCP can accurately demonstrate the normal pancreatic duct as well as various pancreatic duct abnormalities, including congenital anomalies of the biliary tree and pancreatic duct.
磁共振胰胆管造影（MRCP）是一种无创诊断方法，能够生成胆管树和胰管的高质量图像。我们评估了MRCP描绘正常胰管的能力，并根据所获数据研究其在病理性胰管中的应用价值。对42例无胰腺病变的患者以及162例患有胰腺疾病（包括胆管树和胰管先天性异常）的患者进行了MRCP检查。将93例患者的结果与内镜逆行胰胆管造影（ERCP）进行比较。记录胰管及其分支的显影情况以及有无扩张、狭窄和充盈缺损。所有图像均由三名放射科医生进行回顾性盲法解读。在对照组患者中，胰腺头部、体部和尾部的主胰管（MPD）分别在41例（98%）、39例（93%）和31例（74%）中显影，这些患者中胰腺头部、体部和尾部的副胰管及二级分支分别在11例（26%）、8例（19%）、4例（10%）和2例（5%）中显影。与ERCP相比，在胰腺疾病尤其是胰腺炎中，MRCP高估了MPD的狭窄程度，低估了胰管分支的扩张程度和充盈缺损情况。然而，在诊断胰腺黏液产生性肿瘤、囊性病变以及描绘包括梗阻部位远端在内的整体情况方面，MRCP明显优于ERCP。8例胰腺分裂症患者中有4例以及12例胰胆管异常合流患者中有10例也得到了显示。MRCP能够准确显示正常胰管以及各种胰管异常，包括胆管树和胰管的先天性异常。
