莫迪司磁共振胆管成像对胆道形态与排泄功能评估的效果分析  

Morphological and functional evaluation of biliary tract by 3D dynamic enhanced MR examination with multihance

作　　者：孔晓华 麻增林 李志伟 田晞 王曼 冯莉莉 KONG Xiaohua;MA Zenglin;LI Zhiwei(Department of Radiology,the Third Af-filiated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学第三附属医院放射科,100029 [2]北京中医药大学附属护国寺中医医院放射科

出　　处：《临床外科杂志》2020年第4期365-369,共5页Journal of Clinical Surgery

基　　金：北京中医药大学自主课题资助项目(2014-J-YBZZ-JS-068)。

摘　　要：目的观察莫迪司排泄性磁共振胆管成像(Excretory MR cholangiography,eMRCG)对胆道系统的显示效果,并综合评估胆道系统形态与排泄功能。方法经莫迪司MR增强检查且于排泄期显示胆道系统病人24例,对比分析其增强后T1像胆道重建图像与注射造影剂后1小时、2小时及3小时的排泄性磁共振胆管成像(eMRCG-1h、eMRCG-2h、eMRCG-3h)图像对肝内、外胆管与胆囊的显示能力以及对胆管解剖结构与胆管壁的显示效果。结果 (1)eMRCG-2h图像对肝内胆管显示能力优于eMRCG-3h,差异有统计学意义(P<0.05),但与eMRCG-1h比较,差异无统计学意义(P>0.05)。(2)eMRCG-2h、eMRCG-3h图像对肝外胆管的显示能力均优于eMRCG-1h,差异有统计学意义(P<0.05)。(3)eMRCG-3h图像对胆囊的显示能力优于eMRCG-2h和eMRCG-1h,差异有统计学意义(P<0.05),而eMRCG-2h则优于eMRCG-1h,差异有统计学意义(P<0.05)。(4)eMRCG-1h、eMRCG-2h、eMRCG-3h对胆道解剖结构显示效果均优于增强T1胆管重建图像(P<0.05),而eMRCG-1h、eMRCG-2h及eMRCG-3h间比较差异无统计学意义(P>0.05)。(5)增强后T1胆管重建图像对胆管壁的显示效果优于eMRCG-1h、eMRCG-2h、eMRCG-3h,差异有统计学意义(P<0.05),增强后T1胆管重建图像能够显示胆管壁厚度、光滑与否、强化特点、胆管内情况及周围软组织情况。结论应用莫迪司进行排泄性胆道系统成像,具有重要的研究价值和临床应用价值。注射造影剂莫迪司后胆汁排泄期的较为理想的显影时间是注射造影剂后的2小时。Objective To observe the differences of display effects of excretory MR cholangiography(MRCG)to the biliary tract after injection of multihance,and to evaluate the morphology and excretory function of the biliary tract.Methods We selected 24 cases who were examined by MR,and we compared and analyzed the display effects of enhanced T1 biliary tract reconstructing and excretory MRCG images including 1 hour,2 hours and 3 hours after injection of multihance for the intrahepatic and extrahepatic bile duct,gallbladder and bile duct wall.Results(1)The intrahepatic biliary duct display effects of excretory MRCG-2 hours was better than those of excretory MRCG-3 hours(P<0.05),and there were no significant differences between excretory MRCG-1 hour and MRCG-2 hours(P>0.05);(2)the extrahepatic bile duct display effects of excretory MRCG-2 hours and MRCG-3 hours was better than those of excretory MRCG-1 hour(P<0.05);(3)the gallbladder display effect of excretory MRCG-3 hours was better than those of excretory MRCG-2 hour and MRCG-1 hour(P<0.05),and those of MRCG-2 hours was better than those of MRCG-1 hour(P<0.05);(4)the biliary tract anatomic structure display effects of excretory MRCG-1 hour,MRCG-2 hours and MRCG-3 hours was all better than those of enhanced T1 biliary tract reconstructing images(P<0.05);(5)the biliary tract wall display effect of enhanced T1 biliary tract reconstructing images was much better than those of excretory MRCG-1 hour,MRCG-2 hours and MRCG-3 hours(P<0.05),and the enhanced T1 biliary tract reconstructing images can display the biliary tract thickness、smoothness or not,enhancing characteristics,condition in the bile duct and the surrounding soft tissue.Conclusion The excretory MRCG by enhanced scan with multihance has an important research and clinical application value.The ideal biliary tract delay time of bile excretion period is about 2 hours after injection of multihance.

关 键 词：磁共振成像 莫迪司 胆道系统 水成像磁共振胰胆管成像 排泄性胆管成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R657.4[医药卫生—诊断学]