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[磁共振成像,主要是磁共振胰胆管造影术对胆总管结石的诊断]

[Diagnosis of common bile duct stones by MR imaging, mainly MR cholangiopancreatography].

作者信息

Isomoto I, Koshiishi T, Fukuda T, Hayashi K

机构信息

Department of Radiology, Saga National Hospital.

出版信息

Nihon Igaku Hoshasen Gakkai Zasshi. 1998 Sep;58(11):566-71.

PMID:9796263
Abstract

We evaluated the accuracy of MR imaging (MRI), mainly MR cholangiopancreatography (MRCP), in the diagnosis of choledocholithiasis in comparison with ultrasound (US), computed tomography (CT), direct cholangiography, and intravenous cholangiography (DIC). Thirty-seven patients with biliary disease diagnosed by surgery and direct cholangiography underwent MRI with T1-weighted images (T1-WI), T2-weighted images (T2-WI), and MRCP (source images and projection images). The rate of stone detection was evaluated for each MRI image and modality. Fifteen of 37 patients were found to have common bile duct stones at surgery. The depiction rate of T1-WI, T2-WI, source images, and projection images were 7%, 67%, 93%, and 53%, respectively. The depiction rate of MR, US, CT, direct cholangiography, and DIC were 100% (15/15), 25% (3/12), 64% (9/14), 71% (5/7), and 57% (4/7), respectively. In addition, there were two false-positive cases, one of duodenal diverticulum (Lemmel's syndrome) and the other of hemobilia. MRI had a sensitivity of 100%, specificity of 91%, and accuracy of 94% in the diagnosis of common bile duct stones. In conclusion, MRI is useful for evaluating suspected choledocholithiasis. In spite of the high depiction rate of the source images, other images should also be taken into consideration in the diagnosis of choledocholithiasis.

摘要

我们评估了磁共振成像(MRI),主要是磁共振胰胆管造影(MRCP),与超声(US)、计算机断层扫描(CT)、直接胆管造影和静脉胆管造影(DIC)相比,在诊断胆总管结石方面的准确性。37例经手术和直接胆管造影诊断为胆道疾病的患者接受了T1加权成像(T1-WI)、T2加权成像(T2-WI)和MRCP(原始图像和投影图像)的MRI检查。对每个MRI图像和检查方式的结石检出率进行了评估。37例患者中有15例在手术中发现胆总管结石。T1-WI、T2-WI、原始图像和投影图像的显示率分别为7%、67%、93%和53%。MR、US、CT、直接胆管造影和DIC的显示率分别为100%(15/15)、25%(3/12)、64%(9/14)、71%(5/7)和57%(4/7)。此外,有2例假阳性病例,1例为十二指肠憩室(勒梅尔综合征),另1例为胆道出血。MRI在诊断胆总管结石方面的敏感性为100%,特异性为91%,准确性为94%。总之,MRI对于评估疑似胆总管结石是有用的。尽管原始图像的显示率较高,但在诊断胆总管结石时也应考虑其他图像。

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