膈肌导航与相位导航在MRCP 3D成像中的应用  

Clinical application of diaphragma navigation and phase navigation in MRCP 3D imaging

作　　者：卢晶[1] 尚柳彤 李天然[1] 刘靖[1] 雷振星 刘昱含 席佳 LU Jing;SHANG Liutong;LI Tianran(Department of Diagnostic Radiology,The Fourth Medical Center of PLA Gebneral Hospital,Beijing 100048,China)

机构地区：[1]解放军总医院第四医学中心放射诊断科,北京市100048

出　　处：《河北医药》2021年第17期2643-2646,共4页Hebei Medical Journal

摘　　要：目的通过在MR 3D-SPACE可变翻转角的三维快速自旋回波序列中运用膈肌导航与相位导航两种技术进行扫描,比较其成像质量,探讨两种技术的应用价值。方法对150例临床考虑胆道系统疾病的患者分别采用膈肌导航与相位导航3D-SPACE序列进行磁共振胰胆管成像(MRCP)检查,将采集到的影像利用siemens 3D软件进行MIP(maximum intensity projection)重建,比较两种技术图像质量评分、对正常解剖结构的显示能力、对胆囊及胆管结石的检出率并进行分析。将MRCP图像分为呼吸配合组和呼吸配合不佳组,比较两种技术图像质量优良率有无差异。结果采用相位导航的图像质量高于膈肌导航,图像优良率差异有统计学意义(P<0.05)。尤其在呼吸不配合时,相位导航的图像优良率显著高于膈肌导航(P<0.05)。两种导航技术均能较好显示肝内一级胆管、肝外胆管中上段和胆囊,差异无统计学意义(P>0.05)。对于肝内二级胆管,肝外胆管下段,胰管的显示,相位导航明显优于膈肌导航(P<0.05),对肝内胆管结石、胆总管结石的检出结石的检出率分别为97%、98%。结论相位导航能明显消除呼吸运动伪影,解剖细节更清晰,对于肝内二级胆管,肝外胆管下段,胰管的显示较优于膈肌导航,对肝内胆管结石、胆总管结石检出率较膈肌导航高;因此相位导航有较高临床应用价值,临床扫描可推广使用。Objective To compare the imaging quality of diaphragm-navigation and phase-navigation technology in MRCP 3D imaging,and to explore the application value of the two technologies.Methods A total of 150 patients with clinical biliary system diseases wee enrolled in the study,who were examined by diaphragm navigation and phase navigation 3D-space sequence,reconstructing MIP(maximum intensity projection).The image quality scores,display ability of normal anatomy,detection rate of gallbladder and gallstones were observed and compared between the two techniques.Moreover the MRCP images were divided into good respiratory cooperation group and poor respiratory cooperation group,and the good/excellent rate of image quality was observed and compared between the two groups.Results The image quality of phase navigation was superior to that of diaphragm navigation,especially in poor respiratory cooperation group(P<0.05).Both navigation techniques could well show the intrahepatic primary bile duct,upper extrahepatic bile duct and gallbladder,without significant differences between the two metods(P>0.05).The phase navigation was superior to that of diaphragm navigation in showing the intrahepatic secondary bile duct and lower extrahepatic bile duct(P<0.05).Moreover the detection rate of intrahepatic bile duct and total biliary calculi was 97%and 98%,respectively.Conclusion The phase navigation can obviously eliminate respiratory movement artifacts and has clearer anatomical details.And phase navigation is superior to diaphragm navigation in showing the secondary intrahepatic bile duct and the lower segment,the former has higher detection rate of the intrahepatic bile duct and total bile duct stones.Therefore,it is worthy clinical application and promotion.

关 键 词：胰胆管水成像 膈肌导航 相位导航 

分 类 号：R814.46[医药卫生—影像医学与核医学]