Analysis of Different MRI Methods in Diagnosis of Periampullary Diverticulum_West China Medical Journal

Authors：

1MRI Department of Qinhuangdao 1st Hospital, Qinhuangdao Hebei 066000; 2Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041; 3Department of Radiology, Shahe people’s Hospital, Shahe Hebei 054100, China;

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Keywords：

十二指肠乳头旁憩室; MRI; MRCP

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目的:探讨MRI不同检查方法对十二指肠乳头旁憩室(periampullary diverticulum,PAD)的诊断价值。方法:应用MRI多序列检查方法诊断PAD23例,并进行分析。结果:T1WI显示为囊状低信号影,与十二指肠相通者1例,其余22例表现为不均匀略低及高低混杂信号,均未明确诊断;横断位压脂T2WI显示含气液平面囊性病灶15例;冠状位FIESTA序列表现为混杂高信号或高信号影15例;呼吸触发3D MRCP表现为高或混杂高信号影16例;冠状位屏气3DCE LAVA动态增强扫描均清晰显示。其中合并胆系结石13例,胆系炎症及感染13例,胰腺炎3例,胆胰管扩张3例,十二指肠炎症3例。结论:MRI能多序列、多方位、直观、无创的清晰显示PAD的部位、大小、范围及与邻近结构的关系,同时显示胆胰疾病形态学改变。故MRI多序列检查非常必要,是PAD诊断及鉴别诊断的重要方法。

Citation： WANG Zhanqiu,LU Wusheng,WANG Zhanying,et al. Analysis of Different MRI Methods in Diagnosis of Periampullary Diverticulum. West China Medical Journal, 2009, 24(5): 1203-1206. doi: Copy

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1. 张国伟,周杰,廖彩仙,等.十二指肠乳头旁憩室伴胆胰疾病的诊断及外科治疗[J].中国实用外科杂志,2004,24:99100.
2. 李汛,李玉民,曹农,等.乳头周围憩室和胆道疾病的关系探讨[J].中国实用外科杂志,2003,23:1672168.
3. Avisse C, Flament J B, Delatter J, et al. Ampulla of Vater[J]. Surg Clin North Am,2000,80:201212.
4. 霍红军,张杰,李德,等.十二指肠乳头周围憩室与胆道疾病关系的探讨[J].腹部外科,2008,21(2):9495.
5. YILDIRGAN M I, BASOGLU M, YILMAZ I. Periampullary diverticular causing pancreaticobiliary disease[J]. Dig Dis Sci,2004,49:19431945.
6. KIM M H, MYUNG S J, SEO D W, et al. Association of periampullary diverticula with primary choledocholithiasis but not with secondary choledocholithiasis[J]. Endoscopy,1998,30(7):601604.
7. 杨小庆,龚永驰,邵华,等.十二指肠乳头旁憩室综合征影像学诊断价值的研究[J].临床放射学杂志,2004,23:309312.
8. LOBO D N, BALFOUR T W, IFTIKHAR S Y, et al. Periampullary diverticula and pancreaticobiliary disease[J]. Br J Surg,1999,86(5):558597.
9. 梁峰,叶再挺,贾玮玮,等.十二指肠乳头旁憩室的CT、MRI诊断[J].中国医学影像学杂志,2006,14(3):205208.
10. VAN E K, REGAN F. MR cholangiopancreatography using HASTE sequences[J]. Clin Radiol,1999,54(9):588594.
11. 李明山,王丽,耿进朝.低张力MRI对十二指肠乳头区疾病的诊断价值[J].中国临床医学影像杂志,2005,16(1):3033.
12. PAPANIKOLAOU N, KARANTANAS A, MARIS T, et al. MR cholangiopancreatography before and after oral blueberry juice administration[J]. J Comput Assist Tomogr,2000,24(2):229234.
13. CHAN J I B, TSUI E Y, YUEN M K, et al. Gadopentetate dimeglumine as an oral negative gastrointestinal contrast agent for MRCP[J]. Abdom Imaging,2000,25(4):405408.
14. 肖越勇,李杰,李国英,等.低张力MRI与内窥镜对照评价十二指肠乳头区的研究[J].中华放射学杂志,1999,33(1):3941.
15. 王占秋,卢武胜,刘兰祥,等.MRI不同检查方法诊断壶腹区病变的价值[J].华西医学,2008,23(5):10971098.
16. 王豪杰,曾小伟.十二指肠乳头旁憩室综合征的影像学诊断价值[J].中国临床医学影像杂志,2008,19(8):599601.
17. 陈星荣,沈天真,段承祥主编.全身CT和MRI[M].上海:上海医科大学出版社,1994:594596.
18. 闫明勤,郑凯尔,陈峰.同层动态磁共振胰胆管造影对Oddi括约肌功能的评价[J].中国医学影像技术,2004,20(7):10981099.
19. 龚静山,徐坚民,李莹,等.十二指肠乳头旁憩室伴胆胰疾病CT及MRI诊断[J].医学影像学杂志,2006,16(8):811813.

West China Medical Journal

Analysis of Different MRI Methods in Diagnosis of Periampullary Diverticulum

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