活体肝移植供体胆管造影——磁共振胆管水成像和莫迪司增强胆管造影对比  

Comparison of conventional T_2-weighted MR cholangiography with Multihance contrast-enhanced MR cholangiography in evalution of biliary anatomy of liver transplant donor candidates

作　　者：王宏[1] 穆学涛[1] 吴春楠[1] 董玉茹[1] 董悦[1] 臧运金[2] 张惠卿[1] 刘红丽[1] 

机构地区：[1]北京武警总医院医学影像科,北京100039 [2]北京武警总医院肝移植研究所,北京100039

出　　处：《生物医学工程与临床》2009年第3期193-197,共5页Biomedical Engineering and Clinical Medicine

基　　金：武警总医院科研基金(WZ2008008)

摘　　要：目的对比磁共振胆管水成像（T2WI—MRC）和莫迪司对比增强磁共振胆管造影（CE—MRC）对肝移植供体的胆管显示的差别。方法32例肝移植供体，其中男性18例，女性14例，年龄21～63岁，平均年龄35岁。术前行MRC水成像和莫迪司增强后胆管造影检查．对两种检查方法显示肝内外胆管的优缺点进行比较。所有肝移植供体均行术中胆管造影检查。结果2种方法均可清楚显示3级肝内胆管．但T2WI—MRC显示肝内3级以上胆管明显优于CE—MRC（P〈0．05）。T2WI—MRC有5例（15．6％）供体肠道内液体影响胆管显示．CE—MRC则无一例供体肠道液体影响胆管显示。呼吸引起的运动伪影两种检查方法均不明显。胆管变异9例，两种检查方法均正确诊断。2例供体T2WI—MRC显示胆总管不连续，CE—MRC及术中胆管造影显示胆总管正常。结论T2WI—MRC和CE—MRC均可用来评估术前活体肝移植供体胆管解剖，两种检查方法各有优缺点．联合应用将明显提高其诊断准确性。Objective To compare conventional T2-weighted magnetic resonance cholangiography （T2WI-MRC） with Muhihanceenhanced T1-weighted magnetic resonance cholangiography （CE-MRC） for evalution of biliary anatomy in liver transplant donor candidates. Methods A total of 32 healthy liver transplant donor candidates, male 18, female 14, aged 21 - 63 years, mean age 35 years, were examined with two kinds of MR cholangiographic methods. For T2WI-MRC, the three-dimensional turbo spin-echo sequence and oblique coronal heavily T2-weighted thick-slab turbo spin-echo imaging sequence were performed. For CE-MRC, three-dimensional fat-suppressed spoiled gradient-echo sequences were performed, one in the coronal plane and the other in the axial plane, with a time delay of 60 minutes after the administration of Muhihance. Intraoperative cholangiography was the reference-standard examination for liver transplant donor. Results The two methods showed the third branches intrahepatic biliary tract clearly. But the T2WI-MRC was displayed significantly superior to CE-MRC in interhepatic biliary upper the third branches （P 〈 0.05）. Intestinal liquid influenced the image of biliary tract in five cases performed with T2WI-MRC, but no case in CE-MRC. The respirtory motion artifact was not obvious in 2 methods, both methods were able to make correct diagnosis in 9 cases of diagnose the biliary anatomic variants. T2WI-MRC showed common bile ducts intermit in 2 cases, but there were normal in CE-MRC and intraoperative cholangiography. Conclusion T2WI-MRC and CE-MRC could be used to evaluate biliary anatomy of liver transplant donor candidates. There are advantages and disadvantages to each approach, the combined application of 2 methods could significantly improve the accuracy of diagnosis.

关 键 词：活体肝移植 莫迪司 磁共振胆管造影术 

分 类 号：R445.2[医药卫生—影像医学与核医学]