目的探究弥散加权成像(DWI) 联合胰胆管水成像(MRCP)对壶腹部梗阻 性黄疸的诊断价值。方法 选择2015年2 月至2017年2月我院收治的62例因壶腹 部病变所致梗阻性黄疸患者作为研究对 象，30例患者行MRCP扫描，纳入对照 组；32例患者行MRCP联合DWI检查，纳 入观察组。分析所有病例的MRCP征象、 DWI图像质量及信号特征，与病理学检 查结果进行比较。结果 MRCP可清楚显 示胆管系统结构，恶性病变胆管表现为 “软藤样”扩张，DWI可见清晰肿块及胆 囊壁增生；良性病变表现为“枯枝样” 扩张，DWI无特殊征象；对照组总诊断 符合率为63.33%，观察组总诊断符合率 为93.75%，两组比较差异具统计学意义 (χ2 =6.907，P<0.05)。结论 MRCP联合 DWI对壶腹部梗阻性黄疸的诊断效能显著 优于单一MRCP诊断，临床上可将其作为 诊断工作中的参考方案。

Objective To explore the value of diffusion-weighted imaging (DWI) combined with magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of ampullar obstructive jaundice. Methods A total of 62 patients with obstructive jaundice due to ampullar disease treated in the hospital from February 2015 to February 2017 were enrolled as the subjects, 30 patients were scanned by MRCP (the control group) and 32 patients were examined by MRCP and DWI (the observation group). The MRCP signs, DWI image quality and signal characteristics of all cases were analyzed and compared with the pathological examination results. Results MRCP could clearly show the structure of bile duct. The malignant diseased bile duct showed soft rattanlike dilation, and DWI showed clear masses and gallbladder wall hyperplasia. The benign lesion showed dry branch-like dilation. There was no special DWI images. The total diagnostic coincidence rates in the control group and the observation group were 63.33% and 93.75%, respectively (χ2 =6.907, P<0.05). Conclusion The diagnostic efficiency of MRCP combined with DWI for ampullar obstructive jaundice is significantly better than that of single MRCP diagnosis. It can be used as a reference scheme in clinical diagnosis.