肝門部胆管狭窄のCT・MRI

CT and MRI Assessment for Hilar Biliary Stricture

要　旨

肝門部胆管狭窄をきたす疾患は，胆管癌などの悪性腫瘍，原発性硬化性胆管炎やIgG4関連硬化性胆管炎などの炎症性疾患，肝移植後の吻合部狭窄など多岐にわたる。良・悪性の鑑別，悪性腫瘍の手術適応，閉塞性黄疸に対するドレナージ経路の選択などにおけるCTおよびMRIの役割は大きい。本稿では，胆道系疾患に対するCT・MRIの撮像法や代表的疾患における画像所見について概説する。

　There are a wide variety of diseases that cause hilar biliary stricture, including malignant tumors such as cholangiocarcinoma, inflammatory diseases such as primary sclerosing cholangitis and IgG4-related sclerosing cholangitis, and anastomotic stenosis after liver transplantation. CT and MRI play an important role in differentiating between benign and malignant diseases, indications for surgery for malignant tumors, and selection of the drainage route for obstructive jaundice. The imaging protocols of CT and MRI for biliary tract diseases and the imaging findings in each disease will be reviewed.