MRCP对胰腺癌与肿块型慢性胰腺炎的诊断意义.docVIP

MRCP对胰腺癌与慢性胰腺炎的目的材料与方法回顾性分析40例胰腺癌和例慢性胰腺炎资料。结果胰腺癌组主要特征包括：(1)胰管扩张多呈平滑状，并多在肿块处截断()； (2)扩张的胆总管多呈突然截断() ；（3）双管征（19例，占47.5%）；（4）不相交征（20例，占50%）。慢性胰腺炎组的主要特征：(1)胰管扩张多呈不规则型并贯通病变区()； (2)胆总管扩张由上至下逐渐变细()；（3）胰管结石（4例，占20%）；（4）双管征（8例，占40%）。结论胆管扩张的不同磁共振胆胰管成像表现对鉴别胰腺癌和慢性胰炎有诊断价值Abstract】Objective ：To compare the similarities and differences between chronic pancreatitis and pancreatic duct and pancreatic cancer mass type of expansion, so as to improve the differential diagnosis of both. Materials and methods：a retrospective analysis of chronic pancreatitis in Sichuan Provincial Peoples Hospital from 2009 January to 2012 January were treated 40 cases of pancreatic carcinoma and 20 cases of mass MRCP data. Results ：including magnetic resonance cholangiopancreatography main features of pancreatic cancer group: (1) pancreatic duct dilatation in smooth shape (29 cases, 72.5%), and in the mass is truncated at (17 cases, 58.6%); (2) dilatation of the common bile duct was suddenly cut off (22 cases, accounting for 78.6%); (3) double duct sign (19 cases, 47.5%); (4) disjoint syndrome (18 cases, 45%). Including the mass type main cholangiopancreatography features of chronic pancreatitis group: (1) pancreatic duct dilatation is mostly irregular, and through the lesion (6 cases, 46.2%); (2) from top to bottom tapering dilatation of common bile duct (10 cases, 83.3%); (3) of pancreatic duct stones, (4 cases 20%); (4) double duct sign (8 cases, 40%). Conclusion：the different magnetic resonance cholangiopancreatography dilated pancreatic duct in the imaging manifestations of pancreatic carcinoma and chronic pancreatitis with mass diagnosis. 【Key words】pancreatic cancer；chronic pancreatitis；mass type MRCP 前言 胰腺癌与肿块型慢性胰腺炎的鉴别诊断迄今仍是临床工作的难题之一，两者无论是临床表现还是影像学表现都非常相似，鉴别诊断十分困难，胰腺癌的根治性手术存在创伤大、操作复杂、并发症多、死亡率高等特点，因此外科医师都迫切地希望在行胰腺癌根治性手术前获得可靠的诊断依据。此外，由于治疗和预后的不同，鉴别肿块型慢性胰腺炎和胰腺癌显得非常重要。 MRCP是近年来快速发展起来的一种无创性胆胰管成像技术，其原理是利用胆汁和胰液含有大量自由水，其显著长于周围组织的T2弛豫时间的特点，采用重T2加权突出显示前者的信号，从而清楚显示胰胆管的形态学变化。而胰胆管扩张在诊断胰腺病变中有重要意义，近年国内外学者不断优