目的 研究磁核共振成像(MRI)在 胆管内乳头状癌中的临床诊断价值。方法 临床纳入24例我院2015年8月至2017年8月 期间收治的胆管内乳头状肿瘤患者作为研 究对象，所有患者均采用CT和MRI检查， 以病理检查结果作为金标准，分析CT和 MRI对胆管内乳头状癌的诊断情况。结果 MRI及CT共诊断胆管内乳头状癌者24例， 21例经病理确诊为胆管内乳头状癌，另3 例被证实为良性病变；CT诊断17例患者为 胆管内乳头状癌，诊断率为80.95%；MRI 检查显示20例患者为胆管内乳头状癌，诊 断率为95.24%。MRI诊断准确率高于CT，P ＜0.05。两种检查方式在阳性预测值上对 比无差异，P＞0.05；MRI检查在敏感度、 特异度以及阴性预测值上均高于CT检查， P＜0.05。结论 CT、MRI对胆管内乳头状 癌具有较好的诊断价值，影像学特征明 显，其中MRI相对于CT来说对恶性肿瘤的 诊断率更高，影像学表现更典型，值得临 床应用及推广。

Objective To analyze the clinical diagnosis value of MRI (Magnetic Resonance Imaging) in the diagnosis of intraductal papillary neoplasm of the bile duct. Methods A total of 24 patients with intraductal papillary neoplasm of the bile duct treated from August 2015 to August 2017 in our hospital were selected. All patients received the CT and MRI examination. According to the pathological results, the diagnosis value was analyzed. Results According to the pathological results, 21 cases were confirmed of intraductal papillary neoplasm of the bile duct and 3 cases were benign lesions. The CT examination indicated 17 cases and the results were proven of intraductal papillary neoplasm of the bile duct (80.95%). The MRI examination indicated 20 cases were proven with intraductal papillary neoplasm of the bile duct (95.24%); the diagnosis rate based on the MRI was higher than CT (P＜0.05), the positive predictive value based on two examination methods was not significantly different (P＞0.05), the sensitivity, specificity and negative predictive value based on the MRI was higher than CT (P＜0.05). Conclusion Both of CT and MRI have a higher diagnostic value in intraductal papillary neoplasm of the bile duct. MRI has the higher diagnostic accuracy in the malignant tumor and more typical imaging features. It is worthy of clinical application and promotion.