薄层冠扫SSFSE序列在婴幼儿MR胆道成像中的应用  

Application of thin slice coronary SSFSE sequence MRI for displaying infants′ biliary system

作　　者：闫喆[1] 李欣[1] 赵滨[1] 王春祥[1] 

机构地区：[1]天津市儿童医院医学影像科,天津300074

出　　处：《放射学实践》2014年第8期885-888,共4页Radiologic Practice

摘　　要：目的：分析探讨薄层冠扫SSFSE序列在婴幼儿MR胆道成像中的临床应用价值。方法：婴幼儿胆道系统疾病患者24例，包括胆道闭锁7例、胆道扩张症13例、胆系结石4例，均行全腹部薄层冠状面单次激发快速自旋回波（SS-FSE）序列扫描，8例经15～20min延迟后行MRI增强扫描。观察患儿肝内外胆道及其各级分支的解剖全貌、走行分布及通畅情况。结果：所有患儿的MR图像在显示肝胆管解剖方面均可达到质量良好（可显示肝内胆管二级以上分支）。胆道闭锁患儿表现为胆囊形态小或不显影，正常肝外胆道结构消失或显示不完整；胆道扩张症患儿表现为位于胆道走行区的囊性包块，伴或不伴有肝内外胆道不同程度扩张；胆系结石患儿表现为胆道／胆囊内短T2信号充盈缺损，或伴近端胆道扩张。结论：薄层冠扫SSFSE序列具有扫描速度快、呼吸伪影少、无电离辐射、胆道系统与周围背景结构的对比度高等优势，较常规腹部MRI扫描能更细致地观察胆道系统的解剖结构和各级分支的走行、管径，了解病变全貌以及是否合并其它脏器异常，可作为婴幼儿胆道疾病的常规影像学检查手段。Objective：To study the value of MR imaging with thin slice SSFSE sequence in the clinical application of displaying infantst biliary system. Methods：24 infants and young children （10d～3.5y） with biliary tract disease had MR biliary imaging. There were biliary atresia （7 cases）, bile duct dilatation （13 cases） and cholelithiasis （4 cases）. All patients had abdominal thin slice coronary SSFSE sequence scanning;8 patients had contrast enhanced MRI with delay time of 15～ 20min. The anatomy, thoroughness of intra-/ extra-hepatic bile duct and their branches were displayed and studied. Results： The MR images displayed biliary system well in all patients,the second grade intrahepatic bile ducts could be assessed. Pa tients with biliary atresia showed small/absence of gallbladder,disappearance/non integrity of normal extrahepatic bile duct structures. Cystic masses located at biliary system region, accompanied, with or without intra /extra-hepatic bile duct dilata- tion could be seen in patients with bile duct dilatation. Short T2 signal filling defect within gall bladder/bile ducts,accompa- nied with proximal bile duct dilatation could be assessed in patients with cholelithias. Conclusion： Thin slice coronary SSFSE sequence has the advantages including fast scan speed, less breathing artifact, with no ionization radiation, showing strong tissue contrast between biliary system and background structures. More details could be showed when compared with the routine abdominal MRI scan. The anatomy,pathway,diameter of biliary system and the whole view of lesion;as well as any accompanied intra-abdominal abnormality could also be assessed. SSFSE sequence can used as routine approach in displaying infants＇ biliary disorders.

关 键 词：婴幼儿 磁共振成像 磁共振胆胰管成像 胆管疾病 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575.7[医药卫生—诊断学]