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目的研究探讨MRCP对胰头癌的临床诊断的特异征象。方法经手术和病理证实22例胰头癌病例的术前MRCP检查,扫描序列包括SE序列T1WI、FSE序列T2WI、T1WIFS、T2WIFS、MRCP冠状位扫描成像。16例术前行CEMRA肠系膜血管三期扫描成像,显示腹腔动脉、门静脉及肠系膜血管。结果本组21例胰头癌通过MRCP扫描诊断为胰头癌,1例胰头癌误诊为慢性胰头炎。MRCP确诊率为95.4%。本组22例胰头癌MRCP上均有胆总管和主胰管胰头段,因癌瘤侵袭而破坏截断其残留段信号示增高且扩张征象,而且示残存之胆总管与残留主胰管不相交的征象,称之“不相交征”,这是确诊胰头癌的MRCP特异征象。CEMRA显示腹腔动脉、门静脉和肠系膜上静脉受到肿瘤侵袭破坏者分别为3例、3例和4例。结论MRCP扫描“不相交征”对胰头癌诊断有重要作用。
Objective To study the specific signs of MRCP in the clinical diagnosis of pancreatic head cancer. Methods Twenty-two cases of pancreatic head carcinoma were confirmed by operation and pathology. MRCP was performed on the pancreatic cancer including the SE sequence T1WI, the FSE sequence T2WI, T1WIFS, T2WIFS and MRCP coronal scan. Sixteen patients underwent CEMRA mesenteric vascular three-phase scan imaging, showing celiac artery, portal vein and mesenteric vessels. Results Twenty-one cases of pancreatic head cancer were diagnosed as pancreatic head cancer by MRCP scan and one case of pancreatic head cancer was misdiagnosed as chronic pancreatitis. The MRCP diagnosis rate was 95.4%. The group of 22 cases of pancreatic cancer MRCP on both the common bile duct and the main pancreatic duct pancreatic segment, due to invasion and destruction of the tumor rupture the residual segment signal showed increased and expansion of the phenomenon, but also showed residual bile duct and the residual main pancreatic duct is not Intersection signs, called “non-intersecting sign”, which is diagnosed pancreatic cancer of the MRCP-specific signs. CEMRA showed celiac artery, portal vein and superior mesenteric vein tumor invasion and destruction were 3 cases, 3 cases and 4 cases. Conclusion MRCP scan “disjoint” sign has an important role in the diagnosis of pancreatic head cancer.