摘要
目的:探讨磁共振胆胰管成像(MRCP)诊断儿童胆总管囊肿的临床价值。方法:选取2015年1月—2020年12月苏州大学附属儿童医院收治的100例胆总管囊肿患儿,所有研究对象均行磁共振成像(MRI)、MRCP检查,评价MRCP对儿童胆总管囊肿定性诊断的效果。结果:100例胆总管囊肿患儿接受MRI检查,TodaniⅠ型88例,胆总管全程呈囊性扩张并累及左右主肝管,其壁薄而均匀,肝内胆管无扩张,囊状扩张的胆管在T_(1)WI和T_(2)WI上呈水样信号;Ⅱ型3例,胆总管外侧壁囊性低密度影,胆总管侧壁与囊肿样扩张的短蒂或狭窄的基底连接;Ⅲ型2例,胆总管梭状扩张或囊性扩张;Ⅳ型2例,肝外胆管呈囊性扩张,且囊性扩张为多发性,伴或不伴肝内胆管囊性扩张;Ⅴ型5例,可见肝内以周围部分布为主的多发囊性高信号灶,与肝内胆管交通。100例胆总管囊肿患儿接受MRCP检查,Todani分型Ⅰ型88例,肝内胆管无明显扩张,胆总管呈局限性的梭形或囊状扩张,胆总管壁有轻微均一增厚;Ⅱ型2例,胆总管明显扩张,肝管轻度扩张,胆囊下方有明显囊袋样改变,且与胆总管相连;Ⅲ型2例,胆总管末端囊状扩张,胰胆管合流异常;Ⅳ型3例,多个囊状或梭形扩张出现在肝内外胆管,扩张大小不一,胆总管远端有不同程度的狭窄;Ⅴ型5例,有多个串珠状和囊状扩张,扩张沿肝内胆管树分布,扩张囊腔与肝内胆管交通。结论:MRCP利用重T_(2)加权技术,使胆汁和胰液等水性结构呈现明显的高信号,而周围区域呈现低信号,诊断儿童胆总管囊肿的准确率较高。
Objective:To investigate the clinical value of magnetic resonance cholangiopancreatography(MRCP)in the diagnosis of choledochal cyst in children.Method:A total of 100 children with choledochal cyst admitted to Children's Hospital of Soochow University from January 2015 to December 2020 were selected.All subjects underwent magnetic resonance imaging(MRI)and MRCP to evaluate the qualitative diagnosis effect of MRCP on choledochal cyst in children.Result:A total of 100 children with choledochal cyst were examined by MRI.Todani typeⅠ88 cases,the common bile duct cystic dilatation throughout the whole process and involved the left and right main hepatic ducts,the wall was thin and uniform,the intrahepatic bile duct no dilatation,and the cystic dilated bile duct showed water-like signals on T1WI and T2WI.TypeⅡ3 cases,the lateral wall of the common bile duct had a cystic low density shadow,and the lateral wall of the common bile duct was connected with a short pedicle or a narrow basal of cystic dilatation.TypeⅢ2 cases,common bile duct fusiform dilatation or cystic dilatation.TypeⅣ2 cases,extrahepatic bile duct cystic dilatation,and the cystic dilatation was multiple,with or without cystic dilatation of intrahepatic bile duct.TypeⅤ5 cases,multiple cystic hypersignal foci mainly distributed in the peripheral part of the liver,and communicated with the intrahepatic bile duct.A total of 100 children with choledochal cyst were examined by MRCP.Todani typeⅠ88 cases,intrahepatic bile duct dilatation was not obvious,and the common bile duct had localized fusiform or cystic dilatation,and the common bile duct wall was slightly uniform thickened.TypeⅡ2 cases,the common bile duct was obviously dilated,the hepatic duct was slightly dilated,and there were obvious bag-like changes under the gallbladder,which were connected to the common bile duct.TypeⅢ2 cases,the end of the common bile duct cystic dilatation,anomalous pancreaticobiliary ductal junctio.TypeⅣ3 cases,multiple cystic or fusiform dilatation appeared in the intrahepatic and extrahepatic bile duct,the dilatation size was different,and the distal common bile duct had different degrees of stenosis.TypeⅤ5 cases,there were multiple beading and cystic dilatations,which were distributed along the intrahepatic bile duct tree and communicated with the intrahepatic bile duct.Conclusion:MRCP uses heavy T2 weighting technology to make water-based structures such as bile and pancreatic juice show significantly high signal,while the surrounding areas show low signal,and the diagnosis accuracy of children's choledochal cyst is high.
作者
周琦芳
盛茂
郭万亮
陈萌萌
ZHOU Qifang;SHENG Mao;GUO Wanliang;CHEN Mengmeng(Children's Hospital of Soochow University,Suzhou 215000,China;不详)
出处
《中国医学创新》
CAS
2023年第23期119-122,共4页
Medical Innovation of China
