• 四川大學(xué)華西醫(yī)院放射科（成都610041）;

目的　 探討磁共振（MR）對(duì)Ⅰ型先天性膽管囊腫及其合并癥的診斷及術(shù)前評(píng)估價(jià)值。
方法 　回顧分析13例Ⅰ型先天性膽管囊腫及合并癥的MR影像特點(diǎn)，并與手術(shù)結(jié)果比較。MR檢查序列包括軸位T2WI、T1WI平掃，真穩(wěn)態(tài)自由進(jìn)動(dòng)快速成像序列（true-FISP)冠狀面掃描,2D-MRCP和軸位Gd劑增強(qiáng)T1WI掃描。
結(jié)果 　13例患者均表現(xiàn)為膽總管呈囊狀擴(kuò)張。①6例合并結(jié)石及感染，表現(xiàn)為囊壁均勻增厚和明顯強(qiáng)化，囊腫內(nèi)結(jié)石影。②合并膽管癌7例，其中4例以膽管壁不規(guī)則增厚為主要表現(xiàn),3例表現(xiàn)為腔內(nèi)的軟組織腫塊； 6例一期手術(shù)切除，1例因廣泛局部浸潤(rùn)而行姑息手術(shù)治療。13例的MR影像特點(diǎn)與手術(shù)結(jié)果完全相符合。
結(jié)論 　MR不僅能清晰顯示先天性膽總管囊腫，而且還能準(zhǔn)確診斷其合并癥。

引用本文： 夏進(jìn)東,宋彬,周翔平. Ⅰ型先天性膽管囊腫及合并癥的MR診斷與術(shù)前評(píng)估. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007, 14(3): 354-358. doi: 復(fù)制

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  1. 1. Todani T, Watanabe Y, Narusue M, et al. Congenital bile duct cysts: Classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst [J]. Am J Surg， 1977; 134(2)∶263.
  2. 2. 李正， 王慧貞， 吉士俊主編. 先天性畸形學(xué) [M]. 北京： 人民衛(wèi)生出版社， 1999∶694~698.
  3. 3. Babbitt DP. Congenital choledochal cysts: new etiological concept based on anomalous relationships of the common bile duct and pancreatic bulb [J]. Ann Radiol, 1969; 12(3)∶231.
  4. 4. Komi N, Tamura T, Miyoshi Y, et al. Nationwide survey of cases of choledochal cyst. Analysis of coexistent anomalies, complications and surgical treatment in 645 cases [J]. Surg Gastroenterol， 1984; 3(2)∶69.
  5. 5. 李果珍主編. 臨床CT診斷學(xué) [M]. 北京: 中國(guó)科學(xué)技術(shù)出版社, 1996∶457~460.
  6. 6. 黃志強(qiáng)主編. 黃志強(qiáng)膽道外科學(xué) [M]. 北京: 人民軍醫(yī)出版社, 1993∶158~164.
  7. 7. Chijiiwa K, Koga A. Surgical management and long-term follow-up of patients with choledochal cysts [J]. Am J Surg， 1993; 165(2)∶238.
  8. 8. Todani T, Watanabe Y, Toki A, et al. Carcinoma related to choledochal cysts with internal drainage operations [J]. Surg Gynecol Obstet， 1987; 164(1)∶61.
  9. 9. Reveille RM, Van Stiegmann G, Everson GT. Increased secondary bile acids in a choledochal cyst. Possible role in biliary metaplasia and carcinoma [J]. Gastroenterology， 1990; 99(2)∶525.
  10. 10. Han JK, Choi BI. Carcinoma in a choledochal cyst [J]. Abdom Imaging， 1996; 21(2)∶179.
  11. 11. 鄔穎華， 宋彬， 徐雋， 等. VIBE序列在原發(fā)性肝癌MRI診斷中的價(jià)值 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2005; 12(2)∶184.
  12. 12. 鄔穎華， 宋彬， 徐雋， 等. MRI VIBE 序列動(dòng)態(tài)增強(qiáng)對(duì)肝臟局灶性病變的診斷價(jià)值 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2006; 13(2)∶227.
  13. 13. Yoshida H, Itai Y, Minami M, et al. Biliary malignancies occurring in choledochal cysts [J]. Radiology， 1989; 173(2)∶389.
  14. 14. Todani T, Tabuchi K, Watanabe Y, et al. Carcinoma arising in the wall of congenital bile duct cysts [J]. Cancer， 1979; 44(3)∶1134.