Study On The Application Of MRCP To Obstructive In Syndrome Differentiattion Of TCM

Purpose: To evaluate the value of the magnetic resonance cholangiography (MRCP) in diagnosing Syndrome types of TCM jaundice of Yin-Huang and TCM jaundice of Yang-Huang to obstructive jaundice by analyzed image of MRCP and MRI.Materials and Methods: 72patients with obstructive jaundice were performed both MRCP and MRI, whom contents 49male and 23female from 9 to 85 years old, the average age is 57.82. Including 17 cases of intrahepatic tumor formation, 25 cases of per hepatic tumor formation, 12 cases of common bile duct stones, 8 cases of congenital cyst and 10 cases of inflammation. All of them has specificated clinical or surgical and histopathologic data. The one who been suspected has tumor formation should perform intensive MRI scan.Absolute diet for 4 to 12 hours before the MRI examination can display bile duct and gallbladder clearly. The 3%compound solution of Gd-DTPA was taken to restrain the high signals from remaining liquid in stomach .Tell the patients take breath treatment to prepared for hold-breath during the examination.Use GE Signa Contour 0.57 ( USA) Magnetic Resonance Imaging machine, performed in QD Body Flex II normal T1WI, T2WI and STIR (shot tall inversion recovery) . SSFSE Long TE Cholangio Slab TE: 1273.8, Band Width: 10.42, For 35, Scan Time: 3s, Slice Thickness: 80-90, spacing: 0.0, Freq: 256, Phase: 160, NEX: 1.00.And in SSFSE Cholangio Thin Slice TE: 1273.8, Band Width: 10.42, Fov35, Scan Time: 24-26s, Slice Thickness: 10.0, spacing: 0.0, Freq: 256, Phase: 160. NEX: 1.00. The one who can not hold breath for long time performed with RTr FSE MRCP TE: 260, Band Width: 10.42, Echo Train Length Fov40, Scan Time: 360s, Slice Thickness: 3.0, spacing: 0.0, Freq: 256, Phase: 160, NEX: 4.00.Using the theory of the TCM and modern medical image, make detachment of all the data in to Syndrome types of TCM jaundice of Yin-Huang with TCM jaundice of Yang-Huang. Establish the objective assess styles of it. The correlation in extent of dilatation of perihepatic bile duct and the Syndrome types of TCM jaundice of Yin-Huang and Yang-Huang, in the Guibaud grades of dilatation of common bile duct there have three styles:I. the diameter of common bile duct more than 7mm, only have dilatation in perihepatic bile duct;II. the diameter of common bile duct more than 10mm, the dilatation of intrahepatic less than two-thirds;III. the diameter of common bile duct more than 13mm, the dilatation of intrahepatic more than two-thirds.The correlation with dilatation shape and Syndrome types of TCM jaundice of Yin-Huang and Syndrome types of TCM jaundice of Yang-Huang.Results:The images of all the bile ducts and pancreatic duct were showed clearly, of all cases included 41.66% of Yang-Huang, which contents stones, inflammations and congenital cyst, consist of style I and II, the majority shape style is soft canes-like, the average age is 46.7; 55.34%of Yin-Huang, which contents both intrahepatic and perihepatic tumor formation, consist in style II and III, the majority shape style is soft bines-like, the average age is 61.31. In statistics, there shown highly relationships between grades of dilatation and Syndrome styles, also shown distinct relationships between shapes and Syndrome styles, obviously distinction between the Yin-Huang and Yang-Huang. Conclusion:MRCP can reveal the conformation, location of the common bile duct, gallbladder and the relationship of the texture around them clearly, give a solid objective opinion to diagnoses Syndrome types of TCM in obstructive jaundice.