目的 探討磁共振(MR)對Ⅰ型先天性膽管囊腫及其合并癥的診斷及術前評估價值。
方法 回顧分析13例Ⅰ型先天性膽管囊腫及合并癥的MR影像特點,并與手術結果比較。MR檢查序列包括軸位T2WI、T1WI平掃,真穩態自由進動快速成像序列(true-FISP)冠狀面掃描,2D-MRCP和軸位Gd劑增強T1WI掃描。
結果 13例患者均表現為膽總管呈囊狀擴張。①6例合并結石及感染,表現為囊壁均勻增厚和明顯強化,囊腫內結石影。②合并膽管癌7例,其中4例以膽管壁不規則增厚為主要表現,3例表現為腔內的軟組織腫塊; 6例一期手術切除,1例因廣泛局部浸潤而行姑息手術治療。13例的MR影像特點與手術結果完全相符合。
結論 MR不僅能清晰顯示先天性膽總管囊腫,而且還能準確診斷其合并癥。
引用本文:
夏進東,宋彬,周翔平. Ⅰ型先天性膽管囊腫及合并癥的MR診斷與術前評估. 中國普外基礎與臨床雜志, 2007, 14(3): 354-358. doi:
復制
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李正, 王慧貞, 吉士俊主編. 先天性畸形學 [M]. 北京: 人民衛生出版社, 1999∶694~698.
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鄔穎華, 宋彬, 徐雋, 等. VIBE序列在原發性肝癌MRI診斷中的價值 [J]. 中國普外基礎與臨床雜志, 2005; 12(2)∶184.
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鄔穎華, 宋彬, 徐雋, 等. MRI VIBE 序列動態增強對肝臟局灶性病變的診斷價值 [J]. 中國普外基礎與臨床雜志, 2006; 13(2)∶227.
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Yoshida H, Itai Y, Minami M, et al. Biliary malignancies occurring in choledochal cysts [J]. Radiology, 1989; 173(2)∶389.
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Todani T, Tabuchi K, Watanabe Y, et al. Carcinoma arising in the wall of congenital bile duct cysts [J]. Cancer, 1979; 44(3)∶1134.
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- 1. Todani T, Watanabe Y, Narusue M, et al. Congenital bile duct cysts: Classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst [J]. Am J Surg, 1977; 134(2)∶263.
- 2. 李正, 王慧貞, 吉士俊主編. 先天性畸形學 [M]. 北京: 人民衛生出版社, 1999∶694~698.
- 3. Babbitt DP. Congenital choledochal cysts: new etiological concept based on anomalous relationships of the common bile duct and pancreatic bulb [J]. Ann Radiol, 1969; 12(3)∶231.
- 4. Komi N, Tamura T, Miyoshi Y, et al. Nationwide survey of cases of choledochal cyst. Analysis of coexistent anomalies, complications and surgical treatment in 645 cases [J]. Surg Gastroenterol, 1984; 3(2)∶69.
- 5. 李果珍主編. 臨床CT診斷學 [M]. 北京: 中國科學技術出版社, 1996∶457~460.
- 6. 黃志強主編. 黃志強膽道外科學 [M]. 北京: 人民軍醫出版社, 1993∶158~164.
- 7. Chijiiwa K, Koga A. Surgical management and long-term follow-up of patients with choledochal cysts [J]. Am J Surg, 1993; 165(2)∶238.
- 8. Todani T, Watanabe Y, Toki A, et al. Carcinoma related to choledochal cysts with internal drainage operations [J]. Surg Gynecol Obstet, 1987; 164(1)∶61.
- 9. Reveille RM, Van Stiegmann G, Everson GT. Increased secondary bile acids in a choledochal cyst. Possible role in biliary metaplasia and carcinoma [J]. Gastroenterology, 1990; 99(2)∶525.
- 10. Han JK, Choi BI. Carcinoma in a choledochal cyst [J]. Abdom Imaging, 1996; 21(2)∶179.
- 11. 鄔穎華, 宋彬, 徐雋, 等. VIBE序列在原發性肝癌MRI診斷中的價值 [J]. 中國普外基礎與臨床雜志, 2005; 12(2)∶184.
- 12. 鄔穎華, 宋彬, 徐雋, 等. MRI VIBE 序列動態增強對肝臟局灶性病變的診斷價值 [J]. 中國普外基礎與臨床雜志, 2006; 13(2)∶227.
- 13. Yoshida H, Itai Y, Minami M, et al. Biliary malignancies occurring in choledochal cysts [J]. Radiology, 1989; 173(2)∶389.
- 14. Todani T, Tabuchi K, Watanabe Y, et al. Carcinoma arising in the wall of congenital bile duct cysts [J]. Cancer, 1979; 44(3)∶1134.