慢性乙肝患者胆囊壁水肿的MRI表现  

MRI Appearance of Gallbladder Wall Edema in Patients with Chronic Hepatitis B

作　　者：舒健[1] 赵建农[2] 韩福刚[1] 唐光才[1] 何晓鹏[1] 陈欣[1] 罗丽[1] 

机构地区：[1]泸州医学院附属医院放射科,646000 [2]重庆医科大学第二附属医院放射科,400010

出　　处：《临床放射学杂志》2011年第12期1775-1778,共4页Journal of Clinical Radiology

摘　　要：目的探讨胆囊壁水肿的MRI特征及评估慢性乙肝病理变化的价值。资料与方法慢性乙肝67例,正常18例。扫描序列包括T1WI、T2WI、快速采集稳态进动梯度回波(FIESTA)及动态增强扫描。观察有无胆囊壁水肿及其厚度。结果胆囊壁水肿12例,平均厚度为(5.68±3.78)mm。中度慢性肝炎(G3)、重度慢性肝炎(G4)各6例。各组间胆囊壁水肿出现率差异有统计学意义(P=0.000)。G3、G4间差异无统计学意义(P=0.729)。轻度组与中重度组间差异有统计学意义(P=0.000),正常组与中重度组间差异有统计学意义(P=0.005)。各组间胆囊壁水肿厚度差异无统计学意义(t=1.255,P=0.252)。肝纤维化各组(S0～S4)内胆囊壁水肿出现率差异无统计学意义(P=0.124)。胆囊壁水肿预示中重度慢性肝炎的敏感性33.33%,特异性100%。结论 MRI能敏感地显示胆囊壁水肿。胆囊壁水肿提示慢性乙肝中重度炎症活动,具有较高特异性。Objective To describe MRI appearance of gallbladder wall edema and assess its value in determining the pathology of chronic hepatitis B.Materials and Methods Sixty seven patients who were clinically and histologically diagnosed with chronic hepatitis B and 18 healthy subjects without history of liver disease underwent abdominal MR examination.The major imaging protocols included axial breath hold fat suppressed fast spoiled gradient echo T1 weighted imaging,axial breath trigger fat suppressed fast recovery fast spin echo T2WI,axial and coronal fast imaging employing steady-state acquisition,and triple-phase dynamic MR imaging with liver acquisition with volume acceleration sequence.Gallbladder wall edemas were noted.Results There were 12 patients had gallbladder wall edema,with a mean value of（5.68±3.78） mm in edema thickness,including 6 patients with grade 3 and 6 patients with grade 4,respectively.There was significant difference for gallbladder wall edema among grade groups（P=0.000）.There was no significant difference between grade 3 and 4（P=0.729）.The P-value for gallbladder wall edema was 0.000 between mild and moderate-advanced group and 0.005 between normal and moderate-advanced group.There was no significant difference for gallbladder wall edema thickness among grade groups（t=1.255,P=0.252）.The P-value for gallbladder wall edema was 0.124 among stage groups.The sensitivity and specificity of gallbladder wall edema for the diagnosis of moderate-advanced inflammatory activity in chronic hepatitis B were 33.33% and 100%,respectively.Conclusion Gallbladder wall edemas can be discover sensitively by MR imaging,which suggest moderate-advanced inflammatory activity for the patients with chronic hepatitis B,with a higher specificity.

关 键 词：慢性乙型肝炎 胆囊壁水肿 磁共振成像 

分 类 号：R512.62[医药卫生—内科学]