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胆道闭锁(BA)预后与手术日龄密切相关,早期诊断并同婴儿肝炎综合征(IHS)等鉴别极为重要。主要影像学诊断方法是超声显像(US)、磁共振成像(MRCP)、胆管造影及放射性核素肝胆显像(HBS)等。这些检查方法既有各自独特的优势,也有其相应不足。US对BA的特异性和对IHS灵敏度较高,但对BA的灵敏度较低;而肝胆显像对BA的诊断具有极高的灵敏度,其特异性受胆汁淤积等影响较大;MRCP能显示胆管结构,但受其条件、设备影响;胆管造影虽为金标准,但难度和创伤性较大。本文将BA和IHS影像学诊断、鉴别诊断及其进展综述如下。
The prognosis of biliary atresia (BA) is closely related to the age of operation. Early diagnosis and identification with infant hepatitis syndrome (IHS) are very important. The main imaging diagnostic methods are ultrasound imaging (US), magnetic resonance imaging (MRCP), cholangiography and radionuclide hepatobiliary imaging (HBS) and so on. These inspection methods have their own unique advantages, but also its corresponding deficiencies. US specificity of BA and IHS high sensitivity, but lower sensitivity to BA; and hepatobiliary imaging of the diagnosis of BA has a high sensitivity, its specificity is greatly affected by cholestasis; MRCP can show the bile duct Structure, but by its conditions, equipment; bile duct angiography although the gold standard, but more difficult and traumatic. This article will BA and IHS imaging diagnosis, differential diagnosis and its progress are summarized below.