中国临床解剖学杂志 ›› 2010, Vol. 28 ›› Issue (2): 181-.

• 断层影像解剖 • 上一篇    下一篇

胆囊管低位的MRCP诊断

袁 飞,  刘银社,  赵 军, 袁 滨, 张忠强, 艾克文   

  1. 武警医学院附属医院放射科,  天津   300162
  • 收稿日期:2009-07-06 出版日期:2010-03-25 发布日期:2010-04-13
  • 作者简介:袁 飞(1968-),女,满族,辽宁省沈阳市人,博士,副主任医师,主要从事磁共振诊断和新技术应用及研究工作,Tel: (022)60578847

The diagnosis of MR cholangiopancreatography on the low junction of cystic duct

YUAN Fei, LIU Yin-she , ZHAO Jun, et al.   

  1. Department of Radiology, The Affiliated Hospital of Medical College of Chinese People's Armed Police Force, Tianjin 300162 ,  China
  • Received:2009-07-06 Online:2010-03-25 Published:2010-04-13

摘要:

    目的 探讨磁共振胰胆管成像(MRCP)对胆囊管低位的诊断价值及临床意义。 方法 搜集 2004年4月~2009年6月期间行MRCP检查的304例病人的图像进行回顾性分析,测量胆总管末端到左右肝管分叉处的距离(a)和从胆总管末端到胆囊管汇合处的距离(b),其比值(b/a)小于0.33(或1/3)者为胆囊管低位。同时确定胆囊管的汇合方位、长度、直径及其并发症。  结果 304例病人中诊断胆囊管低位者占3.6%(11例),其中72.7%(8例)的胆囊管低位者的胆囊管汇入点位于胆总管左侧壁,后侧壁为18.2%(2例),右侧壁为9.1%(1例)。除1例10岁儿童的胆囊管长为38.5mm外,其余均大于40mm的正常最大值。63.6%(7例)的胆囊管低位者合并胆囊结石、胆囊炎。  结论 MRCP是确定胆囊管低位的一种快速、有效及无创性检查方法,对手术设计及避免胆道损伤起着重要作用。

关键词: 胆囊管低位, 胰胆管造影术, 磁共振, 磁共振成像

Abstract:

Objective    To assess clinical significance and value of magnetic resonance cholangio- pancreatography (MRCP) as a noninvasive method to evaluate the low junction of the cystic duct.Methods 304 patients undergoing MRCP from April 2004 to June 2009 were evaluated retrospectively.The low junction of cystic duct was defined when the cystic junction was detected in the lower third of the common bile duct. The location of insertion, the length and diameter of cystic duct and the associated lesions were also evaluated.   Results Low junction of the cystic duct was clearly assessed in11 patients by MRCP. The cystic duct inserted to the left side of the common bile duct in 8 patients, to the posterior side in 2 cases and to the right side in 1 patient. The length of cystic duct exceeded 40mm except one 10 years old patient with 38.5mm. 7 cases were associated with cholecystitis and gallstone.  Conclusions    MRCP is a useful, rapid, and non-invasive method for demonstrating the low junction of the cystic duct. Diagnosis of this anatomic variation prior to surgery may be helpful for procedures choice and preventing iatrogenic injury to bile ducts.

Key words: Low junction of the cystic duct, Cho1angiopancreatogtaphy, Magnetic resonance, magnetic resonance imaging

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