【摘要】 目的探讨磁共振胆道造影(MRC)在评价胆系手术后胆道并发症的应用价值。方法24例经临床和手术证实的胆系术后胆道并发症患者,行MR常规扫描同时行磁共振胆道造影检查。采用快速自旋回波重T2WI三维数据采集,最大信号强度投影(MIP)重建。结果胆-肠吻合术后吻合口狭窄4例,MRC表现为截断状、鼠尾状或串珠状狭窄。胆-肠吻合术后吻合口瘘2例,MRC能显示吻合口瘘道。胆囊切除加胆总管切开取石术后胆总管残留结石8例,胆总管狭窄4例,表现为边缘光滑锐利杯口状低信号充盈缺损,以及胆总管局限性、节段性狭窄。腹腔镜胆囊切除术后胆总管狭窄5例,胆瘘1例,表现为胆囊管平面胆总管向心性变窄,以及胆囊管残端过短,往往小于5mm。结论MRC作为一种非侵入性成像技术,能准确评价胆系术后胆道系统的各种并发症,具有很高的临床应用价值。更多还原

【Abstract】 Objective To evaluate the magnetic resonance cholangiography (MRC) for assessing the complication of biliary tract surgery. Methods 24 patients who had complication of biliary tract operation confirmed by clinic and surgery undertook MRC as well as the standard MR examination. Data were collected with FRFSE heavy T2WI 3D digital acquisition and MIP reconstruction was then performed. Results Post-cholangiojejunostomy anastomotic stenosis was revealed in 4 cases, in which truncation sign, salvia sign and beads string sign were shown on MRI. There was anastomotic fistula after cholangiojejunostomy in 2 cases, which was demonstrated by MRC. Residual choledochus stone in 8 cases and stenosis of the common bile duct in 4 cases after cholecystectomy plus choledocholithotomy presented with low signal intensity crater-shaped filling defect with well defined border, while there was circumscribed and segmental stenosis of the common bile duct. Choledochus stenosis found in 5 cases and biliary fistula in 1 case after laprascopic cholecystectomy, showing centripetal stenosis of the common bile duct at cystic duct section and the residual cystic duct usually shorter than 5mm.Conclusion As an non-invasive method, MRC provides precise assessments of various complication after biliary tract surgery, which is highly recommendable in clinic.更多还原