梯度自旋回波容积扫描与快速自旋回波容积扫描两种磁共振胰胆管成像技术对比研究  

A comparative study of 3D GraSE MRCP and 3D TSE MRCP magnetic resonance cholangiopancreatography

作　　者：马锋 张树桐[1] 谢元亮[1] 黄增发 王曦 刘元志 MA Feng;ZHANG Shutong;XIE Yuanliang;HUANG Zengfa;WANG Xi;LIU Yuanzhi(Department of Radiology,Wuhan Central Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China)

机构地区：[1]华中科技大学同济医学院附属武汉中心医院影像科,武汉430014

出　　处：《实用医学杂志》2019年第9期1487-1491,共5页The Journal of Practical Medicine

摘　　要：目的梯度-自旋回波容积扫描(3D GraSE)与快速自旋回波容积扫描(3D TSE)两种磁共振胰胆管成像技术(MRCP)对胰胆管成像的临床诊断价值。方法对100例疑有胰胆管系统疾病的患者同时进行两种MRCP成像方法的扫描:一是快速自旋回波容积扫描(3D TSE MRCP);另一成像方法为梯度-自旋回波容积扫描(3D GraSE MRCP)。根据图像的伪影情况、图像质量以及胰胆管清晰度进行评分,t检验两种扫描方法图像间的差异性;对比分析两组MRCP所检胰胆管系统疾病的病因定性诊断结果,χ2检验两种图像的CNR、扫描方法病因定性诊断结果的差异性。结果 TSE MRCP与GraSE MRCP伪影均比较少见,但是GraSE MRCP呼吸运动伪影明显少于TSE MRCP(P <0.05);两组MRCP图像质量差异无统计学意义(P> 0.05);GraSE MRCP对于胆囊、胆囊管及胆总管的显示更好(P <0.05);TSE MRCP对于肝段胆管以及胰管显示更好(P <0.05);两组MRCP胆总管CNR差异无统计学意义(P> 0.05);两组MRCP对胆管癌、胰头癌、胆总管囊肿、肝段胆管结石的诊断上差异无统计学意义(P> 0.05),对于胆囊及胆总管结石的诊断GraSE MRCP比TSE MRCP更加准确(P <0.05)。结论 3D GraSE MRCP与3D TSE MRCP成像均能很好的显示胰胆管结构与病变,患者呼吸运动好情况下3D TSE MRCP能够得到良好的图像;3D GraSE MRCP能够明显的缩短检查时间,减少呼吸运动伪影,并且在胆囊、胆总管结石的显影和诊断较3D TSE MRCP更有优势。Objective To evaluate the clinical diagnostic value of gradient-spin echo volume scanning (3D GraSE,Gradient and Spin Echo)and fast spin echo volume scanning(3D TSE,Turbo Spin Echo)in pancreaticobiliary duct imaging. Methods 100 patients suspected of pancreaticobiliary diseases were scanned by two MRCP imaging methods simultaneously:one was fast spin echo volume scanning(3D TSE MRCP),the other was gradient-spin echo volume scanning(3D GraSE MRCP). According to the artifacts,image quality and pancreaticobiliary duct clarity ,the difference between the two scanning methods was evaluated by t test. The qualitative diagnosis results of pancreaticobiliary duct diseases detected by MRCP in the two groups were compared and analyzed. The difference of CNR and scanning methods in qualitative diagnosis of pancreaticobiliary duct diseases was examined by χ^2 test. Results TSE MRCP and GraSE MRCP artifacts were rare,but GraSE MRCP respiratory motion artifacts were significantly less than TSE MRCP(P < 0.05);there was no significant difference in MRCP image quality between the two groups(P > 0.05);GraSE MRCP showed better gallbladder,gallbladder duct and common bile duct(P < 0.05);TSE MRCP showed better hepatic segment and pancreatic duct(P < 0.05);and there was no significant difference in CNR of common bile duct between the two groups(P < 0.05). There was no significant difference in the diagnosis of cholangiocarcinoma,pancreatic head cancer,choledochal cyst and hepatolithiasis between the two groups(P > 0.05). GraSE MRCP was more accurate than TSE MRCP in the diagnosis of gallbladder and choledocholithiasis(P < 0.05). Conclusion Both 3D GraSE MRCP and 3D TSE MRCP can display the structure and pathological changes of pancreaticobiliary duct very well. 3D TSE MRCP can obtain good images when patients have good respiratory movement. 3D GraSE MRCP can significantly shorten the examination time and reduce the artifacts of respiratory movement,and has more advantages than 3D TSE MRCP in the develop? ment and diagnosis of gallbla

关 键 词：胰胆管成像 磁共振 自旋回波 胆系疾病 

分 类 号：R445.2[医药卫生—影像医学与核医学]