Pankreatikobilyer Semptomları Olan Hastalarda İnsidental Olarak Saptanan Jukstapapiller Divertiküllerin MRCP Bulguları

Abstract

Keywords

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Pankreatikobilyer Semptomları Olan Hastalarda İnsidental Olarak Saptanan Jukstapapiller Divertiküllerin MRCP Bulguları

Abstract

Amaç: Pankreatikobilyer semptomları olan hastaların MRCP incelemelerinde insidental olarak saptanan 24 jukstapapiller divertikülün (JPD) MRCP bulgularının sunulması ve bunların pankreatik kanal, safra yolları ve pankreas üzerine olan etkilerinin belirlenmesi. Hastalar ve Yöntemler: 1-T MR ünitesinde elde edilen ve arşivlenmiş MRCP görüntüleri iki radyolog tarafından tekrar değerlendirilmiştir. Saptanan JPD’lerin yerleşimi ve boyutları, safra kesesinde veya koledokta taş varlığı, safra kanallarında veya pankreatik kanalda dilatasyon ve ana safra kanalında JPD’ye bağlı olarak oluşan deviasyon not edilmiştir. İntrahepatik safra yolları, koledok, pankreatik kanal, safra kesesi ve pankreas parankimi eşlik eden pankreatikobilyer hastalıklar yönünden değerlendirilmiştir. Bulgular: Saptanan tüm JPD’ler (n=24) duodenum 2. bölümünün medial kesiminde yerleşimliydi. JPD’lerin ortalama çapı 2.25 cm ölçülmüştür. Aksiyel T2-ağırlıklı FSE görüntülerde divertiküllerin %95.8’inde (n=23/24) hava-sıvı seviyesi tespit edilmiştir. Kolesistektomi hikayesi olan 6 hasta de- ğerlendirmeden çıkartıldığında hastaların %44.4’ünde (n=8/18) safra kesesinde taş tespit edilmiştir. Hastaların %45.8’inde (n=11/24) koledokta dilatasyon, %58.3’ünde (n=14/24) intrahepatik safra yollarında dilatasyon, %45.8’inde de (n=11/24) pankreatik kanalda dilatasyon saptanmıştır. Hastaların %12.5’inde (n=3/24) koledokta deviasyon izlenmiştir. Üç olguda (%12.5, n=3/24) koledokolitiyazis saptanmıştır. Sonuç: JPD’lerin saptanmasında ve pankreatikobilyer sistem üzerine olan etkilerinin değerlendirilmesinde MRCP faydalı bir radyolojik yöntemdir. Çalışmamızdaki olgu sayımız fazla olmasa da JPD’nin pankreatikobilyer semptomlara yol açtığını öne sürmekteyiz.

Keywords

• Kolanjiyopankreatografi, Manyetik Rezonans, Duodenum, Divertikül, Jukstapapiller Divertikül, Pankreatikobilyer Semptomlar

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