Value of 3.0T magnetic resonance cholangiopancreatography on diagnosis of congenital biliary malformation in children / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the clinical value of 3.0T magnetic resonance cholangiopancreatography (MRCP) in diagnosis of congenital biliary malformation in children.Methods Magnetic resonance imaging (MRI)and MRCP images,including the source image data and maximum intensity projection (MIP) reconstruction images,were analyzed retrospectively in 83 children with congenital biliary malformation diagnosed at Shanghai Children's Hospital,and their operative results and intraoperative cholangiopancreatography images were compared.Two experienced radiologists independently reviewed the images then they reached diagnostic conclusions by consensus.Eighty-three patients included 35 boys and 48 girls,aged from 20 days to 14 years.Results The MRCP indicated that 69 cases with choledochal cysts were consistent with intraoperative cholangiopancreatography findings,and the common bile duct showed different degrees of saccular and fusiform or columnar expansion with different types(Todani classification type Ⅰ 59 cases,type Ⅱ 1 cases,type Ⅳ a 7 cases,and type V 2 cases).The accuracy of localization and quality were 100％.MRCP demonstrated the anomalous junction of pancreaticobiliary duct in 14 cases.MRCP in 19 cases detected by intraoperative cholangiopancreatography with a sensitivity of 79％ and a specificity of 100％.Among 13 cases of biliary atresia,including 1 case accompanied with peritoneal organ inversion proved by MRI,11 cases of the entire extra—hepatic bile duct could not be completed visually,and 2 cases of small or small triangular signals were seen near the hepatic portal area,with the portal vein,and the left or right branches with 100％ accuracy of localization and quality including 1 case accompanied with peritoneal organ inversion proved by MRI.Congenital absence of gallbladder accompanied with duodenal obstruction was seen in 1 case,no gallbladder was found in the gallbladder fossa by MRCP,but the proximal duodenum was obviously dilated.Surgery confirmed that it was complicated and annular pancreas without gallbladder congenitally.Conclusion 3.0T MRCP is a noninvasive and effective method for diagnosis of congenital biliary malformation in children.It can be used as the preferred technique for diagnosis and long-term follow-ups.