Morikawa M, Fukuda T, Aso N, Uetani M, Hayashi K, Shiogama T, Tsurunaga Y, Fukui H
Nagasaki University School of Medicine.
Nihon Rinsho. 1998 Nov;56(11):2939-45.
We retrospectively reviewed magnetic resonance cholangiopancreatography (MRCP) of 25 patients with acute cholecystitis based on clinical, sonographic and surgical findings. Intramural high signal intensity on MRCP was demonstrated in 22 of the 25 patients (88%), and pericholedochal high signal intensity was observed in 6 of the 25 patients (24%). Pericholecystic or perihepatic fluid was demonstrated in 6 of the 25 patients (24%). Gallbladder stones were identified in all 21 patients (100%) by sonography, in 19 of the 21 (90%) by MRCP and in 11 of 18 patients by CT (CT was not performed in other 3 patients). Common bile duct calculi were detected in all 6 patients (100%) by MRCP, in 2 of the 6 (33%) by sonography, and in 5 of the 6 (50%) by CT with confirmation of surgical finding or endoscopic retrograde cholangiography (ERC). MRCP had a high accuracy in diagnosing acute cholecystitis with the finding of intramural high signal intensity. MRCP is an excellent method to evaluate acute biliary disease and may replace CT and ERC in the preoperative evaluation of acute cholecystitis.
我们基于临床、超声及手术结果，对25例急性胆囊炎患者的磁共振胰胆管造影（MRCP）进行了回顾性分析。25例患者中有22例（88%）在MRCP上显示壁内高信号强度，25例患者中有6例（24%）观察到胆管周围高信号强度。25例患者中有6例（24%）显示胆囊周围或肝周积液。超声检查在所有21例患者（100%）中发现胆囊结石，MRCP在21例中的19例（90%）中发现胆囊结石，CT在18例患者中的11例中发现胆囊结石（其他3例未行CT检查）。MRCP在所有6例患者（100%）中检测到胆总管结石，超声在6例中的2例（33%）中检测到，CT在6例中的5例（50%）中检测到，手术结果或内镜逆行胆管造影（ERC）证实了这些发现。MRCP通过发现壁内高信号强度，在诊断急性胆囊炎方面具有很高的准确性。MRCP是评估急性胆道疾病的一种优秀方法，在急性胆囊炎的术前评估中可能会取代CT和ERC。
