ĐẶC ĐIỂM HÌNH ẢNH NANG ỐNG MẬT CHỦ Ở TRẺ EM TRÊN SIÊU ÂM VÀ CỘNG HƯỞNG TỪ 1.5T

Abstract

Purposes: The description of Imaging characteristics of choledochal cysts in children on Ultrasound and MRI 1.5T
Material and methods: 44 patients were diagnosed choledochal cysts on Ultrasound and/or had Ultrasound and MRCP from 7/2012 to 9/2013 in National Hospital of Pediatrics. 16 patients with choledochal cysts underwent MRCP using a half –Fourier acquisition single-shot turbo spin-echo sequence. MRCP findings were compared with intraoperative cholangiography.
Result: In 44 patients choledochal cysts including 34 girls and 10 boys:age range, 2 months -16 years; mean age 3.4 years. Clinical presentation: abdominal pain is the most common symptom (72.72%), vomiting (63.18%), fever (15.90%), jaundice (13.63%). The type of choledochal cysts (according to Todani): type I (93%), type IVa (7%); Type of dilatation: cystic dilatation (77.27%), fusiform dilatation (22.73%); mean measurement: 39.47mm; stone in cyst (29.5%); intrahepatic duct dilatation (43.18%); gallstone (6.8%). MRCP findings (n=16): with the most common form being typeI 87.5% (14/16), typeIVa 12.5% (2/16); cystic dialatation (93.7%), fusiform dilatation 6.3%. Cystolithiasis (75%); intrahepatic duct dilatation (56,25%). Kappa value was good agreement (k: 0.717-0.738) when compared Ultrasound and MRCP. The presence of the anomalous junction of
pancreaticobiliary duct was revealed by MRCP in only 10 cases of 13 cases choledochal cysts with Kappa value was good agreement (k=0.612) when compared with intraoperative cholangiography.
Conclusion: Ultrasound and MRI showed overall good accuracy in the detection and the classification of choledochal cysts and
revealed associated complications. MR cholangiopancreatography provides information about anomalous pancreaticobiliary ductal union in children with choledochal cyst.