磁共振胰胆管成像术下胆系结石患者胆囊管形态的研究分析

肝脏 ›› 2025, Vol. 30 ›› Issue (8): 1120-1123.

磁共振胰胆管成像术下胆系结石患者胆囊管形态的研究分析

谢毅, 王广勇, 田锐, 加央多吉, 于菲菲

200433 上海海军军医大学特色医学中心普外肝胆外科(谢毅,田锐),消化内科(王广勇),医疗保障中心质量管理科(于菲菲);853200 那曲西藏自治区尼玛县人民医院(加央多吉)

收稿日期:2024-02-17 发布日期:2025-09-19
通讯作者: 于菲菲, yffling@163.com
基金资助:
海军特色医学中心卓优人才工程“优秀青年人才”项目(21TPQN1601);海军军医大学校级基础课题青年项目(2023QN045)

The correlation study of MRCP on the morphology of the cystic duct in patients with bile duct stones

XIE Yi¹, WANG Guang-yong², TIAN Rui¹, JIA YANG Duo-ji³, YU Fei-fei⁴

1. Department of General Surgery and Hepatobiliary Surgery,Naval Medical Center, Naval Medical University,Shanghai 200433, China;
2. Department of Gastroenterology, Naval Medical Center, Naval Medical University,Shanghai 200433, China;
3. Nima County People′s Hospital of Xizang Autonomous Region, Naqu 853200, China;
4. Department of Medical Security Center, Naval Medical Center, Naval Medical University,Shanghai 200433, China

Received:2024-02-17 Published:2025-09-19
Contact: YU Fei-fei,Email: yffling@163.com

摘要/Abstract

摘要： 目的利用磁共振胰胆管造影(MRCP)对胆囊管的不同形态进行分类,以分析与不同胆系结石发病的相关性。方法选取2023年 1月至2023年12月海军军医大学特色医学中心收治的胆系结石患者362例。通过影像观察胆囊管形态,根据胆囊管弯曲程度和成角数量将之分为4种类型,并记录胆囊管长度、汇入高低等。结果 362例胆系结石患者中,1型79例,2型132例,3型71例,4型80例。263例单纯胆囊结石,49例存在胆囊和胆囊管结石(嵌顿),50例胆囊合并胆管结石;最终247例行腹腔镜手术,88例行开腹手术,2例由腹腔镜中转行开腹手术,25例行保守治疗。胆囊管形态和结石部位复杂程度相关系数为0.580 (P<0.0001);病程长短与胆囊管形态呈正相关,相关系数为0.207 (P<0.0001); 胆囊管长度与胆囊管形态呈正相关,相关系数为0.507(P<0.0001)。急性发作、腹部压痛、合并胆囊管结石嵌顿、发作天数与胆囊管长度均为胆囊管形态复杂的独立危险因素。结论胆系结石患者胆囊管形态变异率高,MRCP可准确显示胆囊管解剖变异,对胆系疾病有较好的诊断价值。

关键词: MRCP, 胆囊管形态, 胆囊结石

Abstract: Objective To classify the different shapes of the cystic duct using magnetic resonance cholangiopancreatography (MRCP) imaging and analyze the correlation with the incidence of different biliary stones. Methods Patients who underwent MRCP in our hospital from January 2023 to December 2023 due to gallstones were selected. The morphology of the cystic duct was observed through imaging, and it was classified into four types based on the degree of curvature and number of angles formed. The length of the cystic duct and the height of its confluence were recorded. Results By analyzing and summarizing the morphology of the cystic duct and the incidence of biliary stones in 362 patients with MRCP, a total of 79 cases were classified as type 1; 132 cases of type 2; 71 cases of type 3; 80 cases of type 4. The correlation coefficient between the morphology of the cystic duct and the complexity of the stone site is 0.580 (P<0.0001); The duration of the disease is positively correlated with the morphology of the cystic duct, with a correlation coefficient of 0.207 (P<0.0001); The length of the cystic duct is positively correlated with its morphology, with a correlation coefficient of 0.507 (P<0.0001). Previous acute attacks [OR=9.625, 95% CI (4.966, 18.655), P<0.0001], abdominal tenderness upon admission, concomitant cystic duct stone entrapment , duration of attacks, cystic duct length are all independent risk factors for complex cystic duct morphology. Conclusion The gallbladder and cystic duct exhibit diverse morphological variation in patients with bile duct stones. MRCP can accurately display the current anatomical variations of the cystic duct and has good diagnostic value for biliary diseases.

Key words: Gallbladder duct morphology, MRCP, Cholecystolithiasis

谢毅, 王广勇, 田锐, 加央多吉, 于菲菲. 磁共振胰胆管成像术下胆系结石患者胆囊管形态的研究分析[J]. 肝脏, 2025, 30(8): 1120-1123.

XIE Yi, WANG Guang-yong, TIAN Rui, JIA YANG Duo-ji, YU Fei-fei. The correlation study of MRCP on the morphology of the cystic duct in patients with bile duct stones[J]. Chinese Hepatolgy, 2025, 30(8): 1120-1123.

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