目的探讨磁共振胆管成像(MRC)和十二指肠液引流对婴儿期胆道闭锁(EHBA)与婴儿肝炎综合征(IHS)的鉴别诊断价值。方法应用磁共振和婴儿十二指肠引流管对52例婴儿期持续性阻塞性黄疸行MRC和十二指肠液检查,以胆总管、肝总管显影和十二指肠液检查有胆汁(胆汁酸阳性)并经随访黄疸消退诊断为婴儿肝炎综合征;以胆总管、肝总管未显示,十二指肠液检查无胆汁(胆汁酸阴性)且经外科手术探查诊断为胆道闭锁;并将胆道闭锁MRC及十二指肠检查结果与手术、病理结果对比分析。结果52例患儿中最后有34例确诊为婴儿肝炎综合征,18例确诊为胆道闭锁。34例婴儿肝炎综合征中30例MRC能清楚显示胆总管、肝总管结构,2例显示较小胆囊,2例胆总管、肝总管未显示。首次十二指肠液检查有胆汁31例,3例无胆汁。18例胆道闭锁中13例胆囊、胆总管和肝总管未显示,4例仅显示较小胆囊,1例仅显示较大胆囊,十二指肠液检查均无胆汁。18例确诊为胆道闭锁的患儿中,17例与MRC及十二指肠引流诊断相符。结论十二指肠引流液检查能直接观察有无胆汁,诊断胆道闭锁的敏感性为100%,特异性为91.1%;MRC能显示肝外胆道结构,诊断胆道闭锁的敏感性为94.4%,特异性88.24%;十二指肠与MRC联合诊断胆道闭锁的敏感性94.4%,特异性97.06%,因此二者结合应用能较准确鉴别诊断婴儿肝炎与胆道闭锁。 Objective To investigate the differential diagnosis of infantile biliary atresia (EHBA) and infant hepatitis syndrome (IHS) with magnetic resonance cholangiography (MRC) and duodenal drainage. Methods MRC and duodenal juice were examined in 52 infants with persistent obstructive jaundice by magnetic resonance and infantile duodenal drainage tube. The choledochodules, hepatic duct and duodenal juice were examined for bile ) And follow-up of jaundice subsided diagnosis of infantile hepatitis syndrome; to the common bile duct, hepatic duct did not show duodenal fluid examination without bile (bile acid negative) and was diagnosed by surgical exploration of biliary atresia; and biliary atresia MRC and Duodenal examination results and surgery, pathological results of comparative analysis. Results Of the 52 children, 34 were diagnosed with infantile hepatitis syndrome and 18 were diagnosed as biliary atresia. MRC of 30 cases of 34 cases of infant hepatitis syndrome can clearly show the common bile duct and hepatic duct structure, 2 cases showed smaller gallbladder, 2 cases of common bile duct and common bile duct were not shown. The first duodenal examination of bile in 31 cases, 3 cases without bile. Thirteen cases of gallbladder, common bile duct and common bile duct in 18 cases of biliary atresia were not shown, 4 cases showed only smaller gallbladder, 1 case showed only larger gallbladder, duodenal fluid examination without bile. Of the 18 children diagnosed with biliary atresia, 17 were diagnosed with MRC and duodenal drainage. Conclusion The detection of duodenal drainage fluid can directly observe the presence or absence of bile. The sensitivity and specificity of diagnosing biliary atresia were 100% and 91.1% respectively. MRC showed extrahepatic biliary structure with a sensitivity of 94.4% for diagnosing biliary atresia. Sex 88.24%; duodenum and MRC diagnosis of biliary atresia sensitivity 94.4%, specificity 97.06%, so the combination of the two can be more accurate differential diagnosis of infant hepatitis and biliary atresia.