【Abstract】ObjectiveTo evaluate the clinical value of magnetic resonance cholangiopancreatography (MRCP) in diagnosis of extrahepatic bile duct obstruction. MethodsMRCP images of 42 patients presented clinically with obstructive jaundice were retrospectively reviewed to assess the lumen morphological abnormalities of benign versus malignant bile duct obstructions, with clinicalpathological correlation. ResultsThe bile duct of the 30 cases of benign biliary obstruction presented regular and symmetric dilation, gradual tapering,regular thickening and had a “beaklike” tip. The accuracy of MRCP for evaluating the site and the etiology of the benign biliary obstruction were 100%(30/30) and 97%(29/30) respectively. The bile duct of the 12 cases of malignant biliary obstruction presented irregular and asymmetric dilation,abrupt narrowing or iterruption,irregular thickening and had “dualduct sign”. The accuracy of MRCP for evaluating the site and the etiology of the malignant biliary obstruction were 100%(12/12) and 92%(11/12) respectively. ConclusionMRCP is the noninvasive technique of choice with excellent accuracy for the evaluation of obstructive biliary pathology.
Objective To investigate the CT imaging features of pancreatic fatty replacement and its clinical significance. Methods Three patients with pancreatic fatty replacement detected by CT were retrospectively analyzed. CT examination included plain scan and contrast-enhanced scanning at the arterial and portal venous phases. The shape, size, density, pancreatic lobulation and interlobular spaces, course of the pancreatic duct were carefully observed. The clinic and laboratory data were also analyzed to determine the clinical significance of pancreatic fatty replacement. Results ①Imaging features: Two patients had complete fatty replacement involving the entire pancreas, another one had most fatty replacement sparing the posterior aspect of head and tail. Two patients had regular configuration of pancreas. The size of pancreas was slightly enlarged in 2 patients. Lobular atrophy and widening of interlobular spaces were present in all 3 patients. The pancreatic duct was normal in 3 patients. ②Clinic findings: Chronic diarrhea was present in 3 patients. Two patiens had diabetes （one had chronic cholangitis with choledochal lithiasis）， another one had small stone in the common bile duct. Serum lipase was low in 3 patients, of which one had low serum amylase. Conclusion Pancreatic fatty replacement demonstrates certain characteristic CT appearances, and is usually associated with disturbances of both the endocrine and exocrine functions of the pancreas.
【Abstract】ObjectiveTo investigate the value of volumetric interpolated breathhold examination (3DVIBE) MRI sequence in the diagnosis of functional islet cell tumors of the pancreas. MethodsDedicated MRI scan was performed for 3 patients suspected to have functional islet cell tumors of the pancreas on clinical and laboratory basis. The MRI scan protocol included routine axial T1W and T2W, coronal true fast imaging with steady state procession (TrueFISP) and MRCP, gadoliniumenhanced 3DVIBE dynamic triphasic acquisitions and enhanced 2D GRE T1W scan. The three phases images of 3DVIBE sequence were acquired at 15 s, 40 s and 65 s after injection of contrast agent, corresponding to the early arterial, late arterial and portal venous phase respectively. The imaging features were compared with surgical and pathological findings. ResultsThe triphasic images of 3DVIBE sequence depicted clearly the morphology of small functional islet cell tumors of the pancreas and reflected accurately the characteristics of tumor blood supply, while other MRI sequences might miss these small lesions. ConclusionThinslice and fast dynamic MRI sequence, as exemplified by 3DVIBE sequence, is very useful in the detection and characterization of pancreatic functional islet cell tumors.