[摘要] 目的 对比磁共振胰胆管成像( MRCP)及其原始图像与磁共振常规扫描诊断胆总管结石的价值。方法 应用1.0T超导MRI扫描仪对68例患者( 48例单发或多发胆总管结石以及20例胆总管泥沙样结石)行MRCP扫描及常规轴面FSE序列T2WI扫描。结果 MRCP的MIP图像能清晰显示肝内、外胆管及扩张胰管的形态结构。多数胆总管非泥沙样结石在MRCP的MIP图像及MRI常规T2WI图像均难以准确显示，而仅在MRCP原始图像上显示。MRI常规T2WI图像上，胆总管泥沙样结石均特征性地显示为胆总管内分层状改变，但其在MRCP的MIP图像上仅仅显示为局部信号模糊、减低或信号不均匀；在MRCP原始图像上仅在某一幅图像上显示为胆总管信号减低或信号不均匀。结论 MRCP原始图像和MIP图像以及磁共振常规扫描是分析、诊断胆总管结石的一个有机整体，不能仅仅依靠某一种成像技术诊断胆总管结石。

    [关键词] 磁共振胰胆管成像；胆总管结石；对照研究

    Comparison of magnetic resonance cholangiopancreatography and original images with routine MRI in diagnosing common bile duct lithiasis

    ZHAO Tian-ping,ZHANG Yong,DU Hong,et al.MR Room,Jiaozuo People’s Hospital,Jiaozuo 454002,China

    [Abstract] Objective To evaluate the value of magnetic resonance cholangiopancreatography (MRCP) and original images and routine MRI in diagnosing common bile duct lithiasis.Methods Sixty-eight patients (48 with common bile duct lithiasis and 20 with sandy lithiasis) underwent MRCP with routine axial MR T2 weighted fast spin echo sequences and heavy T2 weighted imaging (T2WI) with fast spin echo sequences.Results Reconstruction with maximum intensity projection (MIP) MRCP could definitely demonstrate the configuration of the bile duct and the enlarged pancreatic duct.Common bile duct stones could not been demonstrated on MIP and routine MRI T2WI,but only been demonstrated on original images of MRCP.On routine MRI T2WI,all of the sandy stones characteristically showed delamination fashion,whereas MIP MRCP only demonstrated local faint signal intensity or asymmetric signal intensity,on original images of MR cholangiopancreatography,the sandy stones only demonstrated lower signal or asymmetric signal intensity.Conclusion MRCP and original images and routine MRI are an organic whole of diagnosing common bile duct lithiasis,none of which is reliable alone. ......