Irie H, Honda H, Jimi M, Yokohata K, Chijiiwa K, Kuroiwa T, Hanada K, Yoshimitsu K, Tajima T, Matsuo S, Suita S, Masuda K
Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
AJR Am J Roentgenol. 1998 Nov;171(5):1381-5. doi: 10.2214/ajr.171.5.9798883.
The aim of this retrospective study was to clarify whether MR cholangiopancreatography (MRCP) is a suitable replacement for ERCP in evaluation of the choledochal cyst.
Sixteen patients (six adult and 10 pediatric) with choledochal cysts underwent MRCP using a half-Fourier acquisition single-shot turbo spin-echo sequence. Extent of the cyst, defects within the biliary tree, and presence or absence of the anomalous junction of the pancreaticobiliary duct were evaluated. Findings were compared with those of ERCP.
MRCP better defined the proximal biliary tree than did ERCP in two patients. Defects within the biliary tree were diagnosed correctly on MRCP in eight patients; however, two defects within the distal common bile duct were missed in pediatric patients. The presence of the anomalous junction of the pancreaticobiliary duct was revealed accurately by MRCP in all adult patients but was revealed accurately in only four of the 10 pediatric patients.
MRCP appears to offer diagnostic information that is equivalent to that of ERCP for assessment of choledochal cysts in adults. In pediatric patients, MRCP should not replace ERCP; however, MRCP can play an important role as a noninvasive examination and should be considered a first-choice imaging technique for evaluation of choledochal cysts.
本回顾性研究旨在阐明磁共振胰胆管造影（MRCP）在评估胆总管囊肿时是否可作为内镜逆行胰胆管造影（ERCP）的合适替代方法。
16例胆总管囊肿患者（6例成人，10例儿童）采用半傅里叶采集单次激发快速自旋回波序列进行MRCP检查。评估囊肿范围、胆管树内的缺损以及胰胆管异常汇合的有无。将结果与ERCP的结果进行比较。
在2例患者中，MRCP对近端胆管树的显示优于ERCP。8例患者在MRCP上正确诊断出胆管树内的缺损；然而，儿科患者中远端胆总管内的2处缺损被漏诊。所有成年患者的胰胆管异常汇合在MRCP上均被准确显示，但10例儿科患者中只有4例被准确显示。
MRCP似乎能提供与ERCP相当的诊断信息，用于评估成人胆总管囊肿。在儿科患者中，MRCP不应替代ERCP；然而，MRCP作为一种无创检查可发挥重要作用，应被视为评估胆总管囊肿的首选成像技术。
