磁共振钆塞酸二钠增强胆道成像评价肝硬化患者胆道功能  

Biliary Tract Function Assessment Using Gd-EOB-DTPA-Enhanced MRI in Patients with Liver Cirrhosis

作　　者：吴建伟[1] 高红[1] 瞿献莉[1] 张艳[1] 艾书跃[1] 

机构地区：[1]解放军第八一医院影像科,南京210002

出　　处：《临床放射学杂志》2015年第9期1495-1499,共5页Journal of Clinical Radiology

基　　金：全军医药卫生科研基金资助项目(编号:11MA052)

摘　　要：目的探讨磁共振钆塞酸二钠增强胆道成像评价胆道功能的可行性。方法纳入53例肝硬化ChildPugh评分A级患者为A级组;31例评分B/C级患者为B/C级组;18名正常成人为对照组。记录所有受试者磁共振钆塞酸二钠动态增强扫描时,延迟5、10、15、20和25 min胆总管、胆囊和十二指肠显影时间,并采用分割χ2检验对各组两两进行比较,P<0.0167为有统计学显著差异。测量延迟25 min胆总管信号强度并比较3组之间的差异。采用Games-Howell法进行3组间的比较,P<0.05为统计学显著差异。结果延迟10 min,B/C级组胆总管显示率明显低于对照组(32%vs 100%,χ2=21.339,P=0.000)和A级组(32%vs 87%,χ2=26.177,P=0.000),延迟20 min,B/C级组低于A级组(87%vs 100%,P=0.016)。延迟10、15、20及25 min,B/C级组胆囊显示率明显低于对照组(6%vs 78%,χ2=26.345,P=0.000;52%vs 100%,χ2=12.552,P=0.000;48%vs 100%,χ2=13.795,P=0.000;48%vs 100%,χ2=13.795,P=0.000)和A级组(6%vs 45%,χ2=13.800,P=0.000;52%vs 81%,χ2=8.153,P=0.004;48%vs 91%,χ2=18.559,P=0.000;48%vs 91%,χ2=18.559,P=0.000)。十二指肠显影在各时间点均无显著差异(P>0.05)。胆总管信号强度在正常人群与肝硬化Child-Pugh A级患者之间无显著差异(P=0.243),而在正常人群、肝硬化Child-Pugh A级与B/C级患者之间均有显著差异(P<0.001)。结论肝硬化尤其是Child-Pugh B/C级患者的胆管、胆囊显影较正常人群延迟,且信号强度降低,磁共振钆塞酸二钠增强胆道成像不仅反映了肝脏功能,也可用来评价胆道功能。Objective To discuss the Feasibility of biliary tract function assessment using Gd-EOB-DTPA-enhanced MRI in patients with cirrhosis. Methods The dynamic and hepatobiliary phase MRI at 5,10,15,20,and 25 minutes after administration of Gd-EOB-DTPA were carried out in 18 normal adults（ control group）,53 patients with Child-Pugh score A（ CP A group） and 31 patients with Child-Pugh score B/C（ CP B/C group）. the visualization timing of common bile duct（ CBD）,gallbladder and duodenum were documented and their differences between two groups were compared using χ2partition test,results were considered significant at P 〈 0. 0167. The signal intensity of CBD were measured and their differences were compared among three groups using Games-Howell test,a P 〈 0. 05 was considered to indicate a statistically significant difference. Results At 10 minutes during hepatobiliary phase,the visualization rate of CBD in CP B / C group was lower than control group（ 32% vs 100%,χ2= 21. 339,P = 0. 000） and than CP A group（ 32% vs 87%,χ2= 26. 177,P =0. 000）,at 20 minutes,the visualization rate of CBD in CP B / C group was lower than CP A group（ 87% vs 100%,P =0. 016）. At the 10,15,20,25 minutes,the visualization rate of gallbladder in CP B / C group was lower than control group（ 6% vs 78%,χ2= 26. 345,P = 0. 000,52% vs 100%,χ2= 12. 552,P = 0. 000,48% vs 100%,χ2= 13. 795,P = 0. 000 and 48% vs 100%,χ2= 13. 795,P = 0. 000） and CP A group（ 6% vs 45%,χ2= 13. 800,P = 0. 000,52% vs 81%,χ2=8. 153,P = 0. 004,48% vs 91%,χ2= 18. 559,P = 0. 000 and 48% vs 91%,χ2= 18. 559,P = 0. 000）. The visualization rate of duodenum had no difference among three group（ P 〉 0. 05）. The signal intensity of CBD at 25 minutes had no difference between control group and CP A group（ P = 0. 243）,but had difference between control group and CP B / C group（ P﹤ 0. 001）,CP A group and CP B/C group（ P ﹤ 0. 001）. Conclusion Compared with control group,the visualization of CBD,gallbladder delayed in patients w

关 键 词：肝硬化 钆塞酸二钠 磁共振成像 胆道成像 

分 类 号：R575.2[医药卫生—消化系统]