口服钆喷酸葡胺MRCP协助诊断十二指肠憩室  

MR cholangiopancreatograpy diagnosis of the duodenal diverticula using oral gadopentetate dimeglumine as negative contrast agent

作　　者：龚静山 朱进 饶梓彬 陈宇 黄国鑫 李莹 徐坚民 

机构地区：[1]广东省深圳市人民医院暨南大学第二临床学院放射科,广东深圳518020

出　　处：《医学影像学杂志》2010年第2期205-207,共3页Journal of Medical Imaging

基　　金：深圳市医学重点学科建设基金资助(编号:2001B07)

摘　　要：目的:探讨口服钆喷酸葡胺(gadopentetate dimeglumine,Gd-DTPA)作为阴性对比剂协助MRCP诊断十二指肠憩室的可行性。方法:对11例意外检出12个十二指肠内侧面纯液性或有不确定小气泡液性信号为主的囊性病灶,拟诊憩室的患者口服稀释Gd-DTPA前后采用屏气厚层半傅立叶采集单激发TSE和前瞻性采集矫正呼吸导航(prospective acquisitioncorrection,PACE)TSE两种序列行MRCP,比较憩室在口服稀释Gd-DTPA前后信号变化。结果:12个病灶中4个表现为纯液性囊状影,8个表现为含不确定少量气泡液性为主的囊状影。在未口服稀释Gd-DTPA的MRCP表现为与十二指肠内侧面的囊状高信号影,口服Gd-DTPA后的MRCP全部12个病灶因充盈对比剂消失,揭示其起源于十二指肠并与肠腔相通,从而明确诊断为憩室。结论:口服稀释Gd-DTPA作为阴性对比剂有助于MRCP获得十二指肠憩室的明确诊断。该方法是可行的,可以作为诊断模棱两可情况下的一种补充,值得在临床推广应用。Objective：To investigate the feasibility of MR cholangiopancreatograpy（MRCP） in the diagnosis of the duodenal diverticula using oral gadopentetate dimeglumine（Gd-DTPA） as negative contrast agent.Methods：MRCP was performed in eleven patients with incident detection of 12 cystic lesions（one patient had two lesions） on the medial aspect of the duodenum before and after oral diluted GdDTPA using breath-hold thick slab half-fourier single-shot TSE and prospective acquisition correction（PACE） TSE sequences.Those lesions were suspected as diverticulun for their position and origin.Results：Among the twelve lesions,eight lesions appeared as fluid rounded collection with a little uncertain gas,while,four as pure fluid collection.On MRCP before oral diluted Gd-DTPA,all diverticula manifested as hyperintensity cystic lesions on the medial aspect of the duodenum.All the twelve lesions disappeared on MRCP after oral diluted Gd-DTPA due to filling with contrast agent,which revealed these entities arising from duodenum and with communication with the duodenal cavity.A definite diagnosis of duodenal diverticulum was obtained.Conclusion：It＇s feasible that using oral diluted Gd-DTPA as negative agent facilitates MRCP to obtain a definite diagnosis of the duodenal diverticula,which is worthy recommending as a supplemental method in equivocal regards.

关 键 词：十二指肠憩室 磁共振胆胰管成像 钆喷酸葡胺 

分 类 号：R656.6[医药卫生—外科学] R445.2[医药卫生—临床医学]