Mirizzi综合征影像学诊断.docVIP

精品论文 参考文献 Mirizzi综合征影像学诊断 李树军（江苏省沭阳县扎下医院普外科 江苏沭阳 223600） 【中图分类号】R445【文献标识码】A【文章编号】1672-5085（2011）48-0060-02 【摘要】目的 探讨各种影像学检查诊断Mirizzi综合征的准确性。方法 对14例经手术证实的Mirizzi综合征术前影像学检查结果进行回顾性分析。结果 B超诊断为胆囊结石11例，诊断为胆总管结石2例，诊断为Mirizzi综合征1例;6例ERCP确诊3例; 5例CT检查中2例正常,诊断为胆囊结石及胆总管结石各1例,1例诊断为Mirizzi综合征；7例MRCP检查3例诊为Mirizzi综合征，诊断为胆囊管结石和胆总管结石各2例。B超、ERCP、CT、MRCP诊断Mirizzi综合征的敏感性分别为7.1%(1/14)、50%(3/6)、20%(1/5)、42.9%(3/7)。结论 Mirizzi综合征临床表现无特异性，正确的术前诊断需要联合多种影像学检查及提高对本病的认识。 【关键词】 胆囊结石 Mirizzi综合征 影像学 诊断 【Abstract】 Objective To discuss the accuracy of varous image to diagnose Mirizzi syndrome.Methods Preoperative image examinations of 14 patients with Mirizzi syndrome proved by operation were analyzed retrospectively.Results 11 patients were diagnosed as cholecystolithiasis,2 patients as choledocholithiasis and 1 patient as Mirizzi syndrome by ultrasonography(US);two out of five patients detected by computer tomography(CT) were diagnosed as normal and one as common duct stone,another as cholecystolithiasis,only one case was diagnosed as Mirizzi syndrome. Six cases were submitted to endoscopic retrograde cholangiopancreatography(ERCP) that revealed Mirizzi syindrome in three;Seven cases were submitted to Magnetic Resonance Cholangiopancreatography(MRCP)that revealed Mirizzi syindrome in three and calculus of cystic duct,choledocholithiasis in two respectively;The sensitivity of US,ERCP,CT,MRCP to diagnose Mirizzi syndrome was 7.1%(1/14)、50%(3/6)、20%(1/5)、42.9%(3/7).Conclusions Clinical manifestation of Mirizzi syndrome has no specificity, definite preoperative diagnosis need combination with various image examinations and to improve recognition of the condition. 【Key words】cholecystolithiasis Mirizzi syndrome image diagnosis 因持续嵌顿和压迫胆囊壶腹部和胆囊颈部的结石引起肝总管狭窄或胆囊胆管瘘以及反复发作的胆囊炎、胆管炎及梗阻性黄疸称为Mirizzi综合征。其发病率约占胆囊结石的0.07～2.7%[1]。Mirizzi综合征是一种少见病,术前诊断比较困难,不充分认识此病易导致术中胆管损伤[2]。本文总结了我院收治的14例Mirizzi综合征的影像学表现。 1 一般资料 收集2000-01月～2010-04月期间我院收治并经过手术证实的Mirizzi综合征14例,其中女9例,男5例,年龄35～76岁,平均