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：

十二指腸乳頭旁憩室; MRI; MRCP

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目的:探討MRI不同檢查方法對十二指腸乳頭旁憩室(periampullary diverticulum,PAD)的診斷價值。方法:應用MRI多序列檢查方法診斷PAD23例,并進行分析。結果:T1WI顯示為囊狀低信號影,與十二指腸相通者1例,其余22例表現為不均勻略低及高低混雜信號,均未明確診斷;橫斷位壓脂T2WI顯示含氣液平面囊性病灶15例;冠狀位FIESTA序列表現為混雜高信號或高信號影15例;呼吸觸發3D MRCP表現為高或混雜高信號影16例;冠狀位屏氣3DCE LAVA動態增強掃描均清晰顯示。其中合并膽系結石13例,膽系炎癥及感染13例,胰腺炎3例,膽胰管擴張3例,十二指腸炎癥3例。結論:MRI能多序列、多方位、直觀、無創的清晰顯示PAD的部位、大小、范圍及與鄰近結構的關系,同時顯示膽胰疾病形態學改變。故MRI多序列檢查非常必要,是PAD診斷及鑒別診斷的重要方法。

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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18.	閆明勤,鄭凱爾,陳峰.同層動態磁共振胰膽管造影對Oddi括約肌功能的評價[J].中國醫學影像技術,2004,20(7):10981099.
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1. 張國偉,周杰,廖彩仙,等.十二指腸乳頭旁憩室伴膽胰疾病的診斷及外科治療[J].中國實用外科雜志,2004,24:99100.
2. 李汛,李玉民,曹農,等.乳頭周圍憩室和膽道疾病的關系探討[J].中國實用外科雜志,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. 霍紅軍,張杰,李德,等.十二指腸乳頭周圍憩室與膽道疾病關系的探討[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. 楊小慶,龔永馳,邵華,等.十二指腸乳頭旁憩室綜合征影像學診斷價值的研究[J].臨床放射學雜志,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,葉再挺,賈瑋瑋,等.十二指腸乳頭旁憩室的CT、MRI診斷[J].中國醫學影像學雜志,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,王麗,耿進朝.低張力MRI對十二指腸乳頭區疾病的診斷價值[J].中國臨床醫學影像雜志,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,李國英,等.低張力MRI與內窺鏡對照評價十二指腸乳頭區的研究[J].中華放射學雜志,1999,33(1):3941.
15. 王占秋,盧武勝,劉蘭祥,等.MRI不同檢查方法診斷壺腹區病變的價值[J].華西醫學,2008,23(5):10971098.
16. 王豪杰,曾小偉.十二指腸乳頭旁憩室綜合征的影像學診斷價值[J].中國臨床醫學影像雜志,2008,19(8):599601.
17. 陳星榮,沈天真,段承祥主編.全身CT和MRI[M].上海:上海醫科大學出版社,1994:594596.
18. 閆明勤,鄭凱爾,陳峰.同層動態磁共振胰膽管造影對Oddi括約肌功能的評價[J].中國醫學影像技術,2004,20(7):10981099.
19. 龔靜山,徐堅民,李瑩,等.十二指腸乳頭旁憩室伴膽胰疾病CT及MRI診斷[J].醫學影像學雜志,2006,16(8):811813.

West China Medical Journal

Analysis of Different MRI Methods in Diagnosis of Periampullary Diverticulum

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