MRCP测量急性胰腺炎胰胆管汇合夹角的临床价值
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摘要
目的探讨磁共振胆胰管成像(MRCP)测量急性胰腺炎(AP)胰胆管汇合夹角的临床价值。方法选择10例AP(A组)患者、10例胰胆管疾病患者(B组)和10例健康体检者(C组),分别行MRCP检查。观察3组胰胆管汇合夹角、胰胆管汇合类型的所占比例,并对AP与胰胆管汇合夹角进行相关性分析。结果 A、B、C 3组胰胆管汇合夹角分别为(63.19±14.84)°、(60.29±16.32)°和(50.37±15.46)°。A、B 2组胰胆管汇合夹角大于C组,差异有统计学意义(P<0.05)。A组胰胆管汇合类型为Ⅴ型、B-P型所占比例均高于B组,胰胆管汇合类型为P-B型所占比例低于B组,差异有统计学意义(P<0.05);C组胰胆管汇合类型为Ⅴ型所占比例高于A、B 2组,胰胆管汇合类型为B-P型、P-B型所占比例均低于A、B 2组,差异有统计学意义(P<0.05)。相关性分析结果显示,AP与胰胆管汇合夹角呈正相关(r=8.401,P<0.05)。结论 MRCP显示的汇合类型和胰胆管汇合夹角是临床诊断AP的重要指标。
Objective To explore the clinical value of magnetic resonance cholangiopancreatography(MRCP) in measuring the angle of pancreaticobiliary junction in patients with acute pancreatitis(AP).Methods The MRCP was performed in 10 patients with AP(group A),10 patients with pancreaticobiliary diseases(group B) and 10 healthy subjects(group C).The angles and types of pancreaticobiliary duct confluence were observed,and the correlation between AP and pancreaticobiliary junction angle was analyzed.Results The confluence angle of pancreaticobiliary ducts in group A((63.19±14.84)°) or group B((60.29±16.32)°) was greater than that in group C((50.37±15.46)°)(P<0.05).Compared with group B,the type of pancreaticobiliary duct confluence proportions of type V and type B-P increased but the proportion of type P-B decreased in group A(P<0.05).Compared with group A、B,the type of pancreaticobiliary duct confluence proportion of type V increased but the proportions of type B-P and type P-B decreased in group C(P<0.05).The correlation analysis showed that AP was positively correlated with the angle of pancreaticobiliary duct confluence(r=8.401,P<0.05).Conclusion The confluence angle of pancreaticobiliary ducts displayed by MRCP is an important indicator for clinical diagnosis of AP.
Objective To explore the clinical value of magnetic resonance cholangiopancreatography(MRCP) in measuring the angle of pancreaticobiliary junction in patients with acute pancreatitis(AP).Methods The MRCP was performed in 10 patients with AP(group A),10 patients with pancreaticobiliary diseases(group B) and 10 healthy subjects(group C).The angles and types of pancreaticobiliary duct confluence were observed,and the correlation between AP and pancreaticobiliary junction angle was analyzed.Results The confluence angle of pancreaticobiliary ducts in group A((63.19±14.84)°) or group B((60.29±16.32)°) was greater than that in group C((50.37±15.46)°)(P<0.05).Compared with group B,the type of pancreaticobiliary duct confluence proportions of type V and type B-P increased but the proportion of type P-B decreased in group A(P<0.05).Compared with group A、B,the type of pancreaticobiliary duct confluence proportion of type V increased but the proportions of type B-P and type P-B decreased in group C(P<0.05).The correlation analysis showed that AP was positively correlated with the angle of pancreaticobiliary duct confluence(r=8.401,P<0.05).Conclusion The confluence angle of pancreaticobiliary ducts displayed by MRCP is an important indicator for clinical diagnosis of AP.
引文
[1] 刘玉珍,吕志武.重症急性胰腺炎临床治疗的研究进展[J].胃肠病学和肝病学杂志,2017,26(5):589-593.
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[3] 边芳,杜焱,顾志强,等.MRCP评价胰胆管汇合分型与急性胰腺炎发病率的关系[J].实用医学杂志,2013,29(2):287-289.
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[6] 程琳,余永强,王成林,等.胰胆管汇合MRCP解剖与胰胆系疾病关系[J].中国CT和MRI杂志,2012,10(1):50-53.
[7] 尹涛,温毅,张延林,等.MRCP探讨胰胆管汇合情况与急性胰腺炎发病关系[J].临床放射学杂志,2011,30(3):363-365.
[8] 刘念,董国礼.胰胆管汇合形态学特征与急性胰腺炎相关性的MRI研究[D].南充:川北医学院,2014.
[9] 中国中西医结合学会普通外科专业委员会.重症急性胰腺炎中西医结合诊治指南(2014年,天津)[J].临床肝胆病杂志,2015,31(3):327-331.
[2] 刘立卷,张宝鑫,司益民.MSCT、MRI诊断急性胰腺炎价值比较[J].当代医学,2016,22(1):93-94.
[3] 边芳,杜焱,顾志强,等.MRCP评价胰胆管汇合分型与急性胰腺炎发病率的关系[J].实用医学杂志,2013,29(2):287-289.
[4] 龚金龙.胰胆管汇合异常的临床研究进展[J].中国普通外科杂志,2017,26(3):375-379.
[5] 陈风,汤琳,蒋晓飞,等.MRCP观察胰胆管合流解剖及意义[J].中国临床解剖学杂志,2013,31(5):539-542.
[6] 程琳,余永强,王成林,等.胰胆管汇合MRCP解剖与胰胆系疾病关系[J].中国CT和MRI杂志,2012,10(1):50-53.
[7] 尹涛,温毅,张延林,等.MRCP探讨胰胆管汇合情况与急性胰腺炎发病关系[J].临床放射学杂志,2011,30(3):363-365.
[8] 刘念,董国礼.胰胆管汇合形态学特征与急性胰腺炎相关性的MRI研究[D].南充:川北医学院,2014.
[9] 中国中西医结合学会普通外科专业委员会.重症急性胰腺炎中西医结合诊治指南(2014年,天津)[J].临床肝胆病杂志,2015,31(3):327-331.