Gd-EOB-DTPA增强MRI对Oddi括约肌及胆囊管功能的动态评估  

Evaluation of the dynamic function of sphincter of Oddi and cystic duct with Gd-EOB-DTPA-enhanced MRI

作　　者：刘洋洋[1] 李莉[2] 唐鹤涵[3] 陈国勇[3] 蔡磊[3] 周荣幸[4] 王海清[5] 刘曦娇[3] 宋彬[3] 

机构地区：[1]重庆医科大学附属第二医院放射科,重庆400010 [2]成都中医药大学附属中医院放射科,四川610072 [3]四川大学华西医院放射科,四川610041 [4]四川大学华西医院胆道科,四川610041 [5]四川省肿瘤医院肝胆胰外科,四川610041

出　　处：《放射学实践》2016年第1期35-39,共5页Radiologic Practice

基　　金：国家自然科学基金面上项目资助项目(81171338;81471658)

摘　　要：目的：探讨正常志愿者行Gd—EOB-DTPA动态增强MRI中，Gd—EOBDTPA在十二指肠内及胆囊内显影的时间，为胆道系统功能障碍疾病的诊断提供依据。方法：前瞻性纳入30例行Gd-EOB-DTPAMRI增强扫描的志愿者，于注射对比剂后第5～90min内连续动态扫描。扫描时间点分别为第5～30min内每间隔1min、第30～60min内每间隔5min、第60～90min内每间隔10min采集一次图像。由2位放射科医生对图像进行共同评估，记录对比剂分别进入十二指肠及胆囊的时间。结果：Gd—EOB-DTPA进入十二指肠的平均时间为（30±23）min，其中注射Gd—EOB-DTPA延迟扫描20min时，对比剂进入十二指肠者所占比例为50．0％（15／30）；延迟30min时所占比例为70．0％（21／30）；延迟60min时所占比例为90．0％（27／30）。对比剂进入胆囊的中位时间为10min（6～29min），其中注射Gd—EOB-DTPA延迟扫描15min时，对比剂进入胆囊者所占比例为83．3％（25／30）；延迟20min时所占比例为93．3％（28／30）；延迟30min时所占比例为100％（30／30）。对比剂进入十二指肠及胆囊时间与年龄无关（P〉0．05）。结论：正常人行Gd—EOB-DTPAMRI增强扫描中，对比剂通过十二指肠乳头进入十二指肠的时间〈60min，而通过胆囊管进入胆囊的时间〈30min，此时间不仅可为Gd-EOB-DTPAMRI增强检查扫描时间方案的制定提供指导，同时可为临床上怀疑Oddi括约肌功能障碍或急性胆囊炎的排除诊断提供依据。Objectives：To evaluate the time of contrast reaching gallbladder and duodenum with Gd-EOB-DTPA-en- hanced MRI in healthy volunteers and to provide evidence for the diagnosis of biliary system dysfunctional disease. Methods： From July 2013 to February 2014,30 healthy volunteers underwent Gd-EOB-DTPA-enhanced MRI prospectively. All volun- teers were fast for 8 hours prior to MR examination. After Gd-EOB-DTPA injection,T1-weighted hepatobiliary phase ima- ges were acquired dynamically with a delay time of 5min to 90min. Images were acquired every minute in the first 5min to 30min,every 5min in the period of 30min to 60min,and every 10min in 60min to 90min. Two radiologists reviewed the ima- ges together to record the time of contrast reaching gallbladder and duodenum. Results：The mean time of contrast reaching the duodenum was （30~23）minutes. The proportion of contrast seen in the duodenum was 50% （15/30 cases） by 20min, 70.0% （21/30 cases） by 30min and 90.0% （27/30 cases） by 60rain. The median time of contrast reaching the gallbladder was 10min （range from 6min to 29rain）. The proportion of the contrast seen in the gallbladder was 70% （21/30 cases） by 15rain,93.3% （28/30 cases） by 20rain and 100.0% （30/30 cases） by 30min. The time of contrast reaching duodenum and gallbladder had no relationship with the age of volunteers （P〉0. 05）. Conclusion： In healthy volunteer, using G＆EOB-DT- PA-enhaneed MR examination,the time of contrast reaching duodenum was less than 60min,less than 30min for gallblad- der. These findings could be used as a guide for the designing of Gd-EOB-DTPA enhanced-MRI protocol and providing func- tional information for the diagnosis, of clinically suspected sphincter of Oddi dysfunction （SOD） and acute cholecystitis.

关 键 词：Gd—EOB-DTPA 磁共振成像 ODDI括约肌功能障碍 胆囊炎 急性 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575.6[医药卫生—诊断学]