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폐쇄성 담관질환의 진단에 있어서 호흡정지 없이 시행한 자기공명담관술의 의의
Non-breath-hold MR Cholangiography for the Evaluation of Obstructive Biliary Diseases

백승연    (이화여자대학교 의과대학 내과학교실  );
  • 초록

    Purpose : MR cholangiography(MRC) in patients with obstructive biliary disease was evaluated in order to compare its role with tat of ERCP or PTC. Materials and Methods : Twenty consecutive patients with obstructive biliary and peribiliary diseases (Eleven biliary and peribiliary carcinomas, seven intrahepatic stone diseases and seven extrahepatic stone diseases) were included and ERCP(16 cases) or PTC(for cases) was performed in all twenty cases. Non-breath-hold, heavily T2-weighted, fast spin echo MRC was carried out and 2-D axial, coronal images and 3-D images with maximum intensity projection protocol were obtained. We regarded ERCP or PTC as the gold standard and then compared MRC with ERCP or PTC retrospectively. Results : In 11 patients with biliary and peribiliary carcinomas, the level of obstrction was depicted in nine cases(83%) on MRC and in six of seven cases(86%) on ECRP. The causes of obstruction were demonstrated in eight cases(73%) on MRC and in six of seven cases(86%) on ECRP. On MRC, seven cases(64%) revealed similar findings to ERCP of PTC. Of seven cases of EHD and seven of IHD stone diseases. EHD stones wee detected in six cases(86%) on MRC and in seven cases (100%) on ERCP, IHD Stones were detected in four cases(57%) on MRC and in five cases(71%) on ERCP. 2D-MRC was superior to 3D-MRC in the detection of stones. The extent and grade of ductal dilatation was accurately revealed in six cases(86%) on MRC and in seven cases(100%) on ERCP of EHD stones, in six cases(86%) on MRC and in three cases(43%) on ERCP of IHD stones. Six cases(86%) of EHD stones and two cases(29%) of IHD stones revealed similar findings between MRC and ERCP. Conclusion : MRC findings were similar to those of ERCP or PTC in the evaluation of malignant biliary diseases or extrahepatic stone diseases and was valuable in their diagnoses. In the evaluation of intrahepatic stone diseases, MRC demonstrated dilated peripheral IHDs with stones more denfinitely than ERCP but in the detection its accuracy was low. Further studies may therefore be needed.


  • 주제어

    Bile ducts, MR .   Bile ducts, stenosis or obstruction.  

  • 참고문헌 (12)

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    5. Evaluation of a non-breath-hold MR cholangiography technique , Macaqulay SE;Schulte SJ;Sekijima JH(et al.) , Radiology / v.196,pp.227-232,
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 저자의 다른 논문

  • 백승연 (4)

    1. 1996 "간경변증 환자에서 간신성증후군을 예측하는 지표로서 신장저항지수의 의의" 대한방사선의학회지 = Journal of the Korean Radiological Society 34 (4): 489~492    
    2. 1997 "위암으로 인한 위절제술 후의 추적 복부 CT상 복강축 주위의 연부조직의 의미" 대한방사선의학회지 = Journal of the Korean Radiological Society 36 (5): 787~793    
    3. 1997 "뮐러관 기형진단에 있어서 자기공명영상의 유용성" 대한방사선의학회지 = Journal of the Korean Radiological Society 37 (6): 1111~1118    
    4. 2000 "양각 자궁과 중격 자궁의 감멸 진단: 자기공명영상에서 자궁 격막 신호 강도의 비교는 유용한가\ulcorner" 대한자기공명의과학회지 = Journal of the Korean society of magnetic resonance in medicine 4 (2): 107~112    

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