小肠病变的MRI检查技术研究  

Study on Techniques of MR Examination in the Diagnosis of Small Bowel Diseases

作　　者：朱炯[1] 许建荣[1] 周滟[1] 华佳[1] 李磊[1] 姚秋英[1] 

机构地区：[1]第二医科大学附属仁济医院放射科,上海200001

出　　处：《放射学实践》2005年第1期40-43,共4页Radiologic Practice

摘　　要：目的 :研究小肠病变的MR检查技术。方法 :选取 2 2例健康志愿者进行检查方法研究 ,6例扫描前 3 0～5 0min口服清水 10 0 0～ 15 0 0ml,5例扫描前 3 0～ 5 0min口服水、甲基纤维素混合液 10 0 0～ 15 0 0ml,11例扫描前 3 0～ 5 0min口服特别配制混合液 (每 10 0 0ml由 2 0 %甘露醇 2 5 0ml、5 %糖盐水 5 0 0ml、水 2 5 0ml所配成 ) 10 0 0～ 15 0 0ml。选取获得手术病理证实的 17例患者进行小肠基本病变征象分析 ,所有病例均同时接受小肠钡灌肠及MRI检查 ,从显示小肠肠壁肿块、肠腔狭窄、肠壁异常改变、肠外病灶压迹、溃疡、粘膜异常 6个方面比较SEB与MR及MRI各序列间的敏感度差异。结果 :口服本实验特别配制混合液能使小肠充盈良好 ,其效果优于其它 2种方法 (P <0 .0 1)。在显示肠壁异常改变、肠外压迹方面 ,MR的敏感性 (94.1%、77.8% )明显高于SBE的敏感性 (2 9.4%、11.1% ) ;在显示溃疡方面 ,SBE的敏感性 (82 .4% )明显高于MR(17.6% ) ;MR各序列对肿块的显示率均较高 ;SE T2 WI对肠壁异常改变的显示率 (94.1% )及对肠腔狭窄的显示率(88.2 % )较高 ;SPIR T2 WI对肠外压迹的显示率 (77.8% )较高 ;SE T2 WI与SPIR T2 WI对粘膜异常的显示率 (5 8.8%、41.2 % )相对高 ;各序列对溃疡的显示率均较低。结论 :?Objective:To study the technique of MR examination in the diagnosis of small bowel disease.Methods:Twenty-two healthy volunteers were divided into three groups:group A,ingestion of water for distention of the bowel before MRI;group B,ingestion of water and methylcellulose;group C,ingestion of a special mixture of mannit,glucose saline and water.17 cases with small bowel disease underwent both MR examination and small bowel enema,and the imaging findings such as stenosis,ulcers and abnormal changes of mucous membran were evaluated and compared.Results:The small bowel in group C could be better demonstrated than that in group A and B (P<0.01).For demonstration of the abnormal changes and external compression of the bowel wall,MRI was markedly more sensitive than SBE.For demonstration of the ulcerative changes,SBE was more sensitive than MRI. There was no significant difference among the sequences of MR in demonstrating the masses.SE-T 2WI could better demonstrate the abnormal changes of the bowel wall and stenosis.SPIR-T 2WI could better demonstrate the external compression of the bowel.SE-T 2WI and SPIR-T 2WI could better demonstrate the abnormal changes of the mucous membrane.All MR sequences could only poorly demonstrate the ulcerative changes of the bowel.Conclusion:Before MR examination of the small bowel,the special mixture of mannit,glucose saline and water can offer better demonatration of the small bowel.For demonstration of the pathologic changes of the small bowel,MRI and SBE have their own advantages and disadvantages.

关 键 词：肠疾病 磁共振成像 放射摄影术 

分 类 号：R445.2[医药卫生—影像医学与核医学] R574.5[医药卫生—诊断学]