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  • The study protocol was approved by the Institutional Ethics Review Committee at Children’s Hospital of Soochow University. Informed consent was signed by subject guardians. All experiments were carried out in strict accordance with the institution guidelines regarding the acquisition and experimental use of human tissues. We retrospectively reviewed the medical records of 48 patients common bile duct dilation hospitalized between January 2009 and December 2014. Inclusion criteria of PBM was 1) the common channel is longer than 5 mm by MRCP and combined by intraoperative cholangiography(IOC); 2) patients with 5 mm or longer common channel had biliary amylase(obtained by IOC) >1,000 U/L. If the cases do not meet these criteria, then the cases were diagnosed as CCC. MRCP was performed before diagnosing of PBM in all cases. Before MRCP, all subjects were maintained in jejunitas for 4 h then MRCP was performed with sedation for subjects 10 years-of-age or younger. A Symphony 1.5 T scanner (Siemens, Erlangen, Germany) with an abdominal phased array coil was used as follows: T1-weighted and T1-weighted fast spin series (field of view 24–28 cm, repetition time [TR] 173 ms, echo time [TE] 2.64 ms, flip angle 70, matrix 256 * 128, radiofrequency (RF) bandwidth 260 Hz/Px) and a T2-weighted sequence (TR 1,000 ms, TE 60 ms, RF bandwidth 230 Hz/Px). For MRCP, half-Fourier acquisition single shot turbo spin echo (HASTE) was used with multilayer thin coronal and axial T2-weighted imaging (TR 1,200 ms, TE 80 ms, slice thickness 4 mm). Oblique thick slabs were acquired in the planes of the common bile and pancreatic ducts. For multi-angle imaging, TR was 4,500 ms, TE 950 ms and slice thickness 60 mm were used. Two radiologists who were unaware of the pathological findings independently reviewed the images and reached consensus through discussion. A diagnosis of PBM was established if the common channel is longer than 5 mm. They also assess the shape of the intrahepatic bile duct and gallbladder, pancreatitis, surgical pathology, symptom profiles, operative notes and pathological records were compared with the imaging findings. Forty-eight CCC patients were assessed for gender, age, biliary amylase and MRCP findings and two groups were established: PBM and non-PBM. Within these groups, age, gender, common bile duct shape, distal position of papilla of Vater, cyst stones and cyst size, gallbladder and pancreatic duct dilation and CCC were assessed as was stomach, duodenal, and small bowel fluid. MRCP helped classify cysts as being smaller or larger than 30 mm. Ages were grouped as infant (younger than one year-of-age) or pediatric (older than one year-of-age) as well. Stomach fluid was documented to occur in the gastric fundus or body and duodenal fluid was defined as occurring in the second, third, or fourth duodenal portion and small bowel fluid was defined as occurring in the lower left or the lower and middle abdominal area. Pancreatic duct dilation was defined as dilation greater than 1 mm. Descending cysts were obviously apparent in the introitus pelvis. Data are presented as number (n) and percentage. Univariate comparisons were made using a nonparametric one-way Wilcoxon rank sum, a χ2, or Fisher’s exact test; depending on statistical distribution. To evaluate risk factors affecting diagnosing PBM by MRCP, a stepwise logistic regression analysis was performed with SAS 8. 0. P<0.05 were considered statistically significant.
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