MRI在小肠疾病诊断中的应用价值  

The clinical value of MRI in the diagnosis of small-bowel diseases

作　　者：郑贤应[1] 李银官[1] 邹莹[2] 曹代荣[1] 倪希和[1] 游瑞雄[1] 方哲明[1] 

机构地区：[1]福建医科大学附属第一医院影像科,福州350005 [2]福建省三明市第一医院放射科

出　　处：《中华放射学杂志》2009年第10期1056-1061,共6页Chinese Journal of Radiology

基　　金：福建省教育厅科研基金资助项目（JA07092）

摘　　要：目的探讨MRI在小肠疾病诊断中的可能性及其临床应用价值。方法63例临床怀疑有小肠疾病的患者及3名志愿者进行了小肠MR平扫及对比增强T1WI，并对肠管显示质量进行评分。将31例经手术或临床证实患者的MR影像诊断结果与临床最终诊断结果相比较，评价MR／诊断的敏感性与准确性；对肿瘤性与非肿瘤性病变肠壁的平均厚度进行Wilcoxon秩和检验，对两者的肠系膜肿大淋巴结、肠壁周围浸润及肠腔狭窄情况分别采用Fisher精确检验。结果66例小肠MR检查均获得成功，图像质量达2分和3分者共62例，占93．9％（62／66）。MR发现病变的敏感性为100％（31／31），诊断的准确率为77．4％（24／31）。31例经手术或临床证实的患者中，肿瘤性病变10例，非肿瘤性病变21例，两者病变肠壁的平均厚度分别为23．0mm（7．0～65．0mm）及5．0mm（2．0～35．0mm），差异有统计学意义（Z=-2．949，P〈0．01）；周围肠系膜淋巴结肿大分别为7及4例，差异有统计学意义（P〈0．05）；肠腔狭窄均为10例，差异有统计学意义（P〈0．01）；病变周围的浸润性病变分别为5及17例，差异无统计学意义（P〉0．05）。结论小肠MR检查安全可靠，能清楚地显示小肠病变的部位与范围，对病变定性诊断具有较高的准确性，是诊断小肠疾病的一种有效的检查方法。Objective To evaluate the feasibility and the clinical value of MRI in the diagnosis of small-bowel disease. Methods Sixty-three patients with suspected small-bowel diseases and 3 volunteers without signs of small bowel disease underwent MRI examination. Thirty-one patients whose diagnoses were confirmed by pathology or clinical results were categorized into two groups （neoplastic and nonneoplastic）. The conspicuity of bowel wall, the sensitivity of MRI in detecting small-bowel lesions, and the accuracy rate of diagnosis were calculated. The average bowel wall thickness between the two groups was assessed by using Wilcoxon signed-rank test. Enlarged mesenteric lymph nodes, mesenteric infiltration, and small-bowel stenosis were analyzed by using Fisher＇s exact test in each group respectively. Results MRI examinations of all 66 subjects were successfully performed. Images were rated on a continuous 4-point scale. Sixty-two cases （93. 9% ） were scored as 2 or3. The diagnoses of 31 patients （neoplastic group （n = 10） and nonneoplastic group （ n = 21 ） were confirmed by pathology or clinical results. The sensitivity, accuracy of MRI in identifying small bowel diseases were 100% （31/31） and 77.4% （24/31） respectively. The average bowel wall thickness of the two groups was 23 mm（7.0-65.0 mm） and 5mm（2. 0-35.0 mm） respectively, and there was a statistically significant difference between the two groups （ Z = - 2. 949, P 〈 0. 01 ）. Enlarged lymph nodes in mesentery were found in 7 cases in neoplastic group and 4 cases in nonneoplastic group, and there was a statistically significant difference between the two group （P 〈 0. 05 ）. Small-bowel stenosis was depicted in 10 cases in both groups and there was a statistically significant difference between the two groups （P 〈0. 01 ）. The mesenteric infiltration sign was seen in 5 cases and 17 cases respectively, and showed no significant difference between the two groups （P 〉 0. 05）. Conclusion MRI can depict the locatio

关 键 词：小肠 肠疾病 磁共振成像 

分 类 号：R686[医药卫生—骨科学]