Study Of The Correlation Of The Intrahepatic Bile Duct Manifestation Of Obstructive Jaundice And Tcm Syndrome Types By 3.0T MR

Objective:According to the ultra-high field strength MRI and MRCP imaging findings of the shape and degree of intrahepatic bile duct dilatation of obstructive jaundice,combined with the content of serum bilirubin to explore the correlation with the syndrome differentiation of TCM jaundice.Methods:A retrospective analysis of 76 cases of obstructive jaundice patients.First,two senior Chinese medicine doctors classified the patients into TCM syndromes,which were divided into Yin-Huang and Yang-Huang.Then through ultra-high field strength MRI and MRCP to observe and measure the morphology and classification of intrahepatic bile duct dilation,laboratory examination of serum bilirubin,and the correlation between these three items and traditional Chinese medicine jaundice.The statistical methods adopted was SPSS23,through the chi-square test and Fisher’s exact correction method,P<0.05 was considered to be statistically significant.Result:1.In the TCM syndrome differentiation of jaundice,patients with cholangitis and bile duct stones account for 45/47(96.7%)in Yang-Huang,and tumor patients account for 2/47(4.3%)in Yang-Huang.The proportion of patients with bile duct stones in Yin-Huang was(13.8%),and the proportion of tumor patients in Yin-Huang was 25/29(86.2%).2.According to the classification of the degree of the intrahepatic bile ducts dilatation,compare the light,moderate and severe in pairs.The difference between mild and moderate dilation was statistically significant(χ2=4.95,P<0.05);the difference between mild and severe dilation was extremely statistically significant(χ2=41.84,P<0.01);and the difference between moderate and severe dilation was extremely statistically significant(P<0.01).3.According to the dilated form of intrahepatic bile duct,it is divided into "deadwood sign","soft rattan sign " and "empty sign".The difference inimaging characteristics between Yin-Huang and Yang-Huang is extremely statistically significant(χ2= 52.60,P<0.01).4.According to the grading of bilirubin in serum,comparisons were taken among any two of hidden jaundice,mild jaundice and moderate jaundice.The difference between invisible jaundice and mild jaundice is not statistically significant(χ2=2.19,P>0.05);The difference between mild jaundice and moderate jaundice is extremely statistically significant(χ2= 8.23,P<0.01);the difference between invisible jaundice and moderate jaundice is extremely statistically significant(P<0.01).Conclusion:1.In the etiology of jaundice and TCM syndrome differentiation,cholangitis and bile duct stones are more commonly in Yang-Huang,and tumors are more commonly in Yin-Huang.2.Under ultra-high field MRCP,the degree of dilation of intrahepatic bile duct of Yin-Huang is more obvious than Yang-Huang.Mild and moderate dilation is more commonly as Yang-Huang,and moderate and severe dilation is more common with Yin-Huang.3.In ultra-high field strength MRCP,intrahepatic bile duct dilatation showed a "deadwood sign" which was closely related to Yang-Huang patients,and "soft rattan sign" and "empty sign" were closely related to Yin-Huang patients.4.According to the level of bilirubin in serum,patients with Yang-Huang often have invisible jaundice and mild jaundice,and patients with Yin-Huang often with moderate jaundice.