MRCP对胰头癌及十二指肠乳头癌诊断价值探讨-东南大学学报医学版

MRCP对胰头癌及十二指肠乳头癌诊断价值探讨

单位：东南大学附属中大医院,放射科,江苏,南京,210009

分类号：R445.2, R735.9, R735.31

出版年·卷·期（页码）：2007·26·第二期（131-134）

摘要：

目的:讨论磁共振胰胆管成像(MRCP)对胰头癌和十二指肠乳头癌的诊断价值及特异征象.方法:回顾性分析我院2002～2005年期间经手术病理检查证实的46例胰头癌和38例十二指肠乳头癌患者MRCP图像特征及部分超声和CT诊断结果.结果: MRCP能够清晰显示胰胆管受累情况,联合常规MR扫描对胰头癌及十二指肠乳头癌的诊断正确率明显高于CT及超声检查(P＜0.005),胰头癌中MRCP四管征出现率为30.4%,双管征为45.7%,十二指肠乳头癌病例中表现出双管征者为57.9%.结论:MRCP联合常规MR扫描诊断胰头癌及十二指肠乳头癌准确率高,应用价值大,且通过MRCP图像的特异征象(双管征、四管征)可区分胰头癌及十二指肠乳头癌.

Objective To investigate the value of magnetic resonance cholangiopancreatography(MRCP) in differential diagnosis of pancreatic carcinomas and duodenal carcinomas.Methods MRCP images,ultrasound and CT features of 46 pancreatic carcinomas and 38 duodenal carcinomas whose final diagnosis were confirmed at surgery or biopsy were analyzed retrospectively.Results The pancreaticobiliary duct were visualized clearly and intuitionistic stereograph could be achieved with the help of MRCP.The accuracy of MRCP in the detection of periampullary carcinomas was higher than CT and US(P<0.005).The four-segment sign was seen in 30.4% of pancreatic carcinomas.The double-duct sign was seen in 45.7% of pancreatic carcinomas and in 57.9% of duodenal carcinomas.Conclusion The accuracy of MRCP in the detection of periampullary carcinomas is high with help of the conventional MR images.The specific MRCP signs(double-duct sign and four-segment sign) can help to discriminate the pancreatic carcinomas and duodenal carcinomas,and elevate the diagnostic accuracy.

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