单次屏气3D-SPACE序列MR胰胆管成像技术的可行性初探  

Feasibility of single breath holding 3D-SPACE MR cholangiopancreatography: a preliminary study

作　　者：郑恩双 薛蕴菁[1] 孙斌[1] 段青[1] 陈智勇[1] 何颖颖 李贵进 张中帅 Zheng Enshuang;Xue Yunjing;Sun Bin;Duan Qing;Chen Zhiyong;He Yingying;Li Guijin;Zhang Zhongshuai(Department of Medical Imaging,Fujian Union Medical College Hospital,Fuzhou 350001,China;MR Research Cooperation Department of Siemens Medical System Co.,Ltd.,Shanghai 201318,China)

机构地区：[1]福建医科大学附属协和医院影像科,福州350001 [2]西门子医疗系统有限公司MR科研合作部,上海201318

出　　处：《中华放射学杂志》2020年第8期799-803,共5页Chinese Journal of Radiology

摘　　要：目的探讨单次屏气高并行采集因子三维可变反转角快速自旋回波(3D-SPACE)序列在MR胰胆管水成像(MRCP)的技术优势。方法前瞻性收集2018年11月至2019年3月在福建医科大学附属协和医院行MRCP检查的75例患者的影像资料,所有患者均需采用单次屏气法(单次屏气高并行采集因子3D-SPACE MRCP序列)和自由呼吸膈肌导航法(自由呼吸膈肌导航的3D-SPACE MRCP序列)进行扫描。比较2种方法扫描时间,以及图像胆总管信噪比(SNR)、胆总管与其周围组织对比度(CR)及胆总管和肝脏之间对比噪声比(CNR),并以4分制分别对整体图像质量、伪影和胆总管、左右肝管、右前支、后支、第2及3段分支、主胰管和胆囊管的可见度进行评分。采用配对t检验及Wilcoxon符号秩检验进行统计学分析。结果单次屏气法的扫描时间(18 s)明显短于自由呼吸膈肌导航法[264(226,313)s],2种方法相比差异有统计学意义(Z=-7.520,P<0.001)。单次屏气法中SNR、CR及CNR(8.31±4.23、0.92±0.30、11.46±5.77)均小于自由呼吸膈肌导航法(11.23±5.70、0.93±0.38、15.06±7.37),2种方法比较差异均有统计学意义(t=4.378、3.429、4.063,P均<0.05)。单次屏气法的整体图像质量、伪影、以及胆总管、左右肝管、右前支、后支、第2及3段分支、主胰管和胆囊管的可见度评分均高于自由呼吸膈肌导航法,2种方法差异均有统计学意义(P均<0.001)。结论相比自由呼吸膈肌导航门控3D-SPACE MRCP序列,单次屏气高并行采集因子3D-SPACE MRCP序列扫描出图像伪影小,胰胆管树可视性高,并缩短了检查时间,提高了工作效率,值得进一步推广。Objective To explore the technical advantages of MR cholangiopancreatography(MRCP)with single breath holding high parallel acquisition factor 3-D variable flip angle fast spin echo(3D-SPACE)sequence.Methods From November 2018 to March 2019,75 patients who underwent MRCP examination in our hospital were prospectively enrolled,with single breath holding high parallel acquisition factor 3D-SPACE sequence and free breathing navigation gated 3D-SPACE sequence.Three experienced radiologists scored the overall image quality,artifacts,CBD visibility,left and right hepatic ducts,right anterior and posterior branches,second and third branches,main pancreatic duct and gallbladder duct with four scales.Paired t test was used for statistical analysis.Results The scanning time of single breath holding method(18 s)was significantly shorter than that of free breathing diaphragm navigation method[264(226,313)s],and the difference between the two methods was statistically significant(Z=-7.520,P<0.001).The SNR,CR and CNR(8.31±4.23,0.92±0.30,11.46±5.77)of single breath holding method were lower than those of free breathing diaphragm navigation method(11.23±5.70,0.93±0.38,15.06±7.37),and the differences between the two methods were also statistically significant(t=4.378,3.429,4.063,P<0.05).The overall image quality,artifact,the CBD,left and right hepatic duct,right anterior and posterior branchs,the second and third branches,main pancreatic duct and cystic duct of single breath holding method were higher than those of free breathing diaphragm navigation method,and the differences between the two methods were statistically significant(P<0.001).Conclusions Compared with the free breathing diaphragm navigation gated 3D-SPACE MRCP imaging method,the single breath holding high parallel acquisition factor 3D-SPACE MRCP imaging method has less artifacts and examination time,but higher visibility to pancreaticobiliary tree and work efficiency,which is worthy of further promotion.

关 键 词：胆总管 磁共振成像 

分 类 号：R575.7[医药卫生—消化系统] R445.2[医药卫生—内科学]