True FISP序列在胰胆管疾病的应用

评价ＴｒｕｅＦＩＳＰ序列在胰胆管疾病中的应用价值与限度。材料与方法,对９８例怀疑胰胆管疾病的患者和１２例正常志愿者做ＴｒｕｅＦＩＳＰ与ＡＳＴＥ－ＭＲＣＰ扫描。结果ＴｒｕｅＦＩＳＰ像、ＭＲＣＰ断层像和ＭＲＣＰＭＩＰ像显示胰胆管扩张的准确性均达到了１００％,对病变定位的准确率分别为９４．４％、８３．３％;对胆管结石定性的准确率（特异性）分别为７３．３％（８８．１％）、９３．３％（９２．９％）和６６．７     

肝癌的影像学评价:1.5T MRI与常规CT、US比较

目的：探讨三种非创伤性影像检查方法ＭＲＩ、ＣＴ和ＵＳ在肝癌诊断中的敏感性和准确性。方法：５２例经病理及临床证实的ＨＣＣ行ＭＲＩ,ＣＴ和ＵＳ检查。结果：ＭＲＩ常规序列与ＦＭＰＳＰＧＲ相比,敏感性以ＳＥＴ２Ｗ及ＦＭＰＳＰＧＲ序列为高。对ＨＣＣ检出总的敏感性依次为ＭＲＩ（ＳＥ＋ＦＭＰＳＰＧＲ）８５．８９％,ＣＴ７５．６４％,ＵＳ７１．７９％,＜３ｃｍＨＣＣ,ＭＲＩ检出的敏感性为７１．４２％明显高于ＣＴ（５１．４２％）和ＵＳ（４５．７１％）,对于＞３ｃｍＨＣＣ,三者敏感性相似。ＨＣＣ定性准确性依次为动态增强ＦＭＰＳＰＧＲ（９２．０６％）,常规ＳＥ序列（８５．９３％）,ＣＴ（８４．７４％）,ＵＳ（７５．００％）,ＳＥ序列结合动态增强ＦＭＰＳＰＧＲ对肝癌定性准确性可达９５％,明显优于ＣＴ和ＵＳ。结论：在ＨＣＣ的检出敏感性和定性诊断上,１．５ＴＭＲＩＳＥ序列结合动态增强ＦＭＰＳＰＧＲ明显优于常规ＣＴ和ＵＳ,为肝癌重要的影像学检查手段。     

胰胆管疾病的磁共振胰胆管成像与内窥镜逆行胰胆管造影初…

目的：探讨磁共振胰胆管成像（ＭＲＣＰ）对胰胆管疾病的临床应用价值。材料与方法：２０例高度怀疑胰胆管疾病的患者均经内窥镜逆行胰胆管造影（ＥＲＣＰ）和ＭＲＣＰ检查，并将ＭＲＣＰ影像与ＥＲＣＰ影像进行非双盲对照分析，其中１５例经手术证实。ＭＲＣＰ采用屏气、一次激发半傅立叶转换快速自旋回波序列（ＦＡＳＥ）、重Ｔ２加权、二维（２Ｄ）多个平面成像技术。结果：冠状位ＭＲＣＰ图像与ＥＲＣＰ图像极其相似，ＭＲＣＰ图     

磁共振胰胆管造影的临床应用

目的：开发磁共振胰胆管造影（ＭＲＣＰ）的应用。材料和方法：采用ＧＥ超导０．５Ｔ，Ｖｅｃｔｒａ２磁共振成像仪，快速自旋回波（ＦＳＥ）重Ｔ２加权扫描及最大强度投影（ＭＩＰ）重建图像。对１１例胰胆病变患者作ＭＲＣＰ检查。结果：１１例均清楚显示胆系结构，结石或肿瘤所造成的充盈缺损或梗阻部位均能准确显示。１例胰头癌还同时清楚可见扩张的胰管。结论：磁共振胰胆管造影（ＭＲＣＰ）有很好的临床应用价值     

单次屏气超快速MRI在胆系梗阻性疾患诊断中的应用

目的 ⑴评估单次屏气半傅立叶采集单次激发快速自旋回波磁共振胆胰管造影（ＨＡＳＴＥ－ＭＲＣＰ）对于胆系梗阻性疾患胆胰管的显示情况及对疾病诊断的准确性。⑵评估单次屏气ＨＡＳＴＥ－ＭＲＣＰ与真稳态进动快速成像（Ｔrue ＦＩＳＰ）Ｔ２＊Ｗ１相结合在胆系梗阻性疾患诊断中的应用价值。方法 １３２例胆系梗阻患者术前行ＭＲ检查（Ｓiemens１．５Ｔ Ｍagnetojm Ｖision）。所有扫描序列均采用单次屏气快速扫描并配以体部相控     

胰胆管疾病的磁共振胰胆管成像与内窥镜逆行胰胆管造影初步对照研究

目的：探讨磁共振胰胆管成像（ＭＲＣＰ）对胰胆管疾病的临床应用价值。材料与方法：２０例高度怀疑胰胆管疾病的患者均经内窥镜逆行胰胆管造影（ＥＲＣＰ）和ＭＲＣＰ检查，并将ＭＲＣＰ影像与ＥＲＣＰ影像进行非双盲对照分析，其中１５例经手术证实。ＭＲＣＰ采用屏气、一次激发半傅立叶转换快速自旋回波序列（ＦＡＳＥ）、重Ｔ２加权、二维（２Ｄ）多个平面成像技术。结果：冠状位ＭＲＣＰ图像与ＥＲＣＰ图像极其相似，ＭＲＣＰ图像的空间分辨率略逊于ＥＲＣＰ，因而，ＭＲＣＰ有时不能显示正常胰管及其分支。依据较满意的ＭＲＣＰ图像可以做出与ＥＲＣＰ基本一致的诊断，并且，对ＥＲＣＰ失败或显示不完全的病例，ＭＲＣＰ可获得有价值的诊断信息。结论：本研究结果表明，ＭＲＣＰ是一种安全、无损伤性的影像学技术，在胰胆管疾病诊断方面具有很大潜力，评价ＭＲＣＰ是否可以常规取代ＥＲＣＰ的诊断作用尚为时过早，仍需要进一步大量的临床病例对照研究。     

磁共振胰胆管成像在胰胆管疾病中的诊断价值

目的：探讨磁共振胰胆管成像（ＭＲ ｃｈｏｌａｎｇｉｏｇｒａｐｈｙ,ＭＲＣＰ）对胰胆管疾病的诊断价值。材料和方法：用ｆａｓｔ－ＡＳＥ序列完成了８２例ＭＲＣＰ检查,其中有６３例经手术病理证实,余为超声或ＣＴ证实,经二维（２Ｄ）及三维（３Ｄ）处理图像,后以最大信号投影重建图像。结果：全部检查均获得成功。良、恶性胰胆管疾病在ＭＲＣＰ图像上具有一定的特征性。ＭＲＣＰ定位及定性准确率分别为１００％及８６％。结论：ＭＲＣＰ是一种无创伤性的有效手段,能清楚显示正常或异常的胰胆管结构,定性和定位准确率高,能为临床提供十分有意义的诊断资料。     

磁共振胰胆管成像的临床应用研究

目的：评价磁共振胰胆管成像（ＭＲＣＰ）的临床应用价值。材料与方法：在Ｐｈｉｌｉｐｓ ＧｙｒｏｓｃａｎＴ１０－ＮＴ１．０超导型磁共振成像仪上进行ＭＲＣＰ检查５８例,其中作为正常对照组１６例,各种胰胆管病变者４２例。ＭＲＣＰ采用不屏气涡轮自旋回波（ＴＳＥ）序列的重度Ｔ２加权像扫描（ＴＲ／ＴＥ＝２０００ｍｓ／７００ｍｓ）,并应用呼吸触发及脂肪抑制技术。图像后处理以最大强度投影法（ＭＩＰ）进行三维（３Ｄ）     

内镜逆行胰胆管造影诊断胰腺癌：附119例分析

笔者通过ＥＲＣＰ（内镜逆行胰胆管造影）检查的１１９例胰腺癌分析．详述了胰腺癌的ＥＲＣＰ表现，提出了ＥＲＣＰ诊断胰腺癌的六型分类法，即：（１）主胰管闭塞型；（２）主胰管狭窄型；（３）主胰管筛孔状破坏型；（４）主胰管受压移位型；（５）胆管梗阻型；（６）主胰管正常型，本组ＥＲＣＰ插管成功率为９３．３％，诊断胰腺癌的敏感性和准确性分别为８９．７％和９４．６％，比同组Ｂ超和ＣＴ高。作者认为，ＥＫＣＰ应作为胰腺癌术前诊断的主导方法。但是，若将Ｂ超、ＥＲＣＰ和ＣＴ合理地结合，术前诊断正确率可进一步提高（本组提高到了１００％）。     

磁共振胆道造影在胆道梗阻定位和定性诊断中的价值

目的：通过ＭＲＩ胆道造影（ＭＲｃｈｏｌａｎｇｉｏｇｒａｐｈｙ，ＭＲＣ）与ＣＴ、ＵＳ、经皮穿刺胆道造影术（ＰＴＣ）或内窥镜逆行胰胆管造影术（ＥＲＣＰ）及手术、病理的对照研究，评价ＭＲＣ显示胆道梗阻部位，确定梗阻原因的能力。材料与方法：３０例梗阻性黄疸的患者在ＧＥＳｉｇｎａ１．５Ｔ超导系统上进行了ＭＲＣ检查，并与ＰＴＣ或ＥＲＣＰ、ＣＴ、ＵＳ、手术及病理对照。结果：本组资料中，ＭＲＣ显示胆道梗阻的部位准确性达１００％，优于有损伤性的ＰＴＣ或ＥＲＣＰ。ＭＲＣ确定梗阻原因的准确性达７０％，类似于ＰＴＣ或ＥＲＣＰ、ＣＴ、ＵＳ。结论：初步研究结果表明，无损伤性的ＭＲ胆道造影在梗阻性黄疸的定位和定性上具有很高的敏感性、准确性，对于梗阻性黄疸，特别是行ＥＲＣＰ失败和不宜行ＰＴＣ或ＥＲＣＰ的病人是最有效的替代方法。     

Juxtapapillary diverticulum: findings on MRI

The purpose of our study was to describe the imaging findings of juxtapapillary diverticulum on magnetic resonance imaging (MRI). The MRI and magnetic resonance cholangiopancreatography (MRCP) examinations of 14 patients with juxtapapillary diverticula that were diagnosed on endoscopic retrograde cholangiopancreatography (ERCP) (N = 8) or endoscopy (N = 6) were retrospectively evaluated. T1-weighted spoiled gradient-echo, T2-weighted half Fourier single shot fast spin-echo (HASTE), and T2-weighted True FISP (fast imaging with steady state precession) images and thin-slice MRCP images were obtained on all patients. In five patients, diluted gadolinium DPTA (1/100) was used as an oral contrast. T2-weighted True FISP and HASTE images demonstrated air-fluid levels within all diverticula. Hyperintense oral contrast on T1-weighted spoiled gradient-echo images aided detection of the smaller diverticula. MRCP images obtained in the coronal plane best demonstrated the relationship of the diverticula to the papilla. MRI with the use of HASTE, True FISP, and oral contrast-enhanced T1-weighted sequences was able to depict juxtapapillary diverticula in our series.     

Magnetic resonance imaging with true fast imaging with steady-state precession and half-Fourier acquisition single-shot turbo spin-echo sequences in cases of suspected placenta accreta

Purpose: To present the magnetic resonance imaging (MRI) findings of placenta accreta in suspected cases of placenta accreta with true fast imaging with steady-state precession (True FISP) and half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequences.

Material and Methods: Five patients underwent MRI with HASTE (n=5) and/or True FISP (n=4) sequences for suspected placenta accreta. Retrospective review of MRI was performed to define the location and extent of the implantation abnormality.

Results: The uteroplacental interface was visualized as three layers; inner low signal intensity layer, middle high signal intensity layer of myometrium, and outer low signal intensity layer of uterine serosa. Three cases were diagnosed with placenta accreta on MRI and focal non-visualization of the inner layer was demonstrated.

Conclusion: The finding of focal non-visualization of the inner layer between the placenta and myometrium by MRI with True FISP and HASTE sequences was the diagnostic finding for placenta accreta.     

口服枸橼酸铁铵在胆胰系MRI中的应用价值评价

目的:评价口服枸橼酸铁铵在胆胰系MRI中的应用价值。方法:对86例怀疑有胰胆管系统疾病的患者行口服枸橼酸铁铵前、后MRCP及常规胆胰系MRI,对服用对比剂前后MRCP图像质量、邻近脏器边缘分辨力及各序列上胃十二指肠腔与肝脏的对比噪声比进行自身对照研究,由资深放射科医生对两组图像进行评价,SPSS统计软件进行统计分析。结果:服用对比剂后TrueFISP及HASTE序列均显示胃、十二指肠腔内信号显著降低,形成阴性对比;而FL2D序列胃、十二指肠腔内信号增强,形成阳性对比;胃十二指肠腔内液体造成的背景高信号被完全抑制,单层法与多层法MRCP图像质量及邻近的肝胆胰等结构边缘分辨力均明显提高。结论:口服枸橼酸铁铵能明显提高胆胰系MRI的成像质量,对诊断胆胰系病变具有重要的临床应用价值。     

True FISP序列对梗阻性黄疸的诊断价值

目的：探讨真稳态进动快速成像（True FISP）序列对梗阻性黄疸病因学及定位诊断的价值和限度。方法：分析经临床证实的32例梗阻性黄疸惠者的MR表现，由3名医生分别采用3种序列组合（True FISP序列冠状位扫描，MRI胆管成像，MRC、True FISP结合常规MR平扫及增强扫描）进行病变的定位及病因学诊断，并与临床及病理结果进行对比分析。结果：三种序列组合均作出了准确的定位诊断。对于胆道及胆道内病变所致梗阻性黄疸，True FISP序列的诊断符合率为78．9％，MRC为84．2％，两者间差异无显著性意义（P〉0．05）。对于胆道外病变所致梗阻性黄疸，True FISP序列的诊断符合率为84．6％，MRC为30．0％，前者优于后者（P＜0．05）。对于各种原因所致梗阻性黄疸，联合运用3种成像方法（MRC、True FISP、常规MR平扫及增强扫描）的诊断符合率为93．8％，明显优于MRC（62．5％，P〈0．01），但与True FISP序列（81．2％）比较，差异无显著性意义（P=0．1）。结论：TrueFISP序列能准确定位梗阻性黄疸的梗阻部位；对于胆外病变所致梗阻性黄疸能提供MRC所不能提供的病变信息，能较准确地对梗阻原因作出定性诊断；如果结合常规平扫及增强扫描，将获得更高的诊断符合率。     

Congenital anomalies of the pancreaticobiliary tract: findings on MR cholangiopancreatography (MRCP) using half-Fourier-acquisition single-shot turbo spin-echo sequence (HASTE).

The clinical significance of magnetic resonance cholangiopancreatography (MRCP) using half-Fourier acquisition single-shot turbo spin-echo (HASTE) in the evaluation of congenital anomalies of pancreaticobiliary tract was demonstrated in 56 patients (man: 31, women: 25; age: 0-60 years old, mean 15 years old) with suspected congenital anomalies of pancreaticobiliary tract. The image quality and characteristics were assessed. MRCP using HASTE with a phased array coil can be used as a non-invasive method for the evaluation of congenital anomalies of the pancreaticobiliary tracts.     

恶性梗阻性黄疸的MRI诊断及评价(附30例分析)

目的:评价磁共振成像对恶性梗阻性黄疸的诊断价值。方法:30例临床怀疑恶性梗阻性黄疸的患者术前行MRI检查。扫描序列包括快速自旋回波(TSE)T1WI、T2WI、压脂后增强扫描、TSE-MRCP和真稳态快速进动成像(TrueFISP)。所得结果与手术及病理所见进行对照。结果:各MRI序列均能准确判断胆管内径、梗阻的部位及程度,其中以MRCP最为快捷方便。术前结合各序列总诊断符合率为86.7%(26/30)。胰头癌在T1WI增强扫描及T2WI平扫上的肿块显示率(均为83.3%)及受侵血管显示率(均为81.3%)高于其它序列。胆管肿瘤在各序列上均能显示,但TrueFISP序列、T1WI增强扫描能较好地显示肿块累及范围。结论:MRCP对评价胆管内径、梗阻的部位及程度优于其它序列,T1WI增强扫描及T2WI平扫能较好显示胰头癌的大小及累及范围,TrueFISP序列和T1WI增强扫描能较好显示胆管肿瘤的大小及累及范围。     

利用自旋回波平面成像T_2加权序列提高肝脏实性病变的检出率

目的　评价自旋回波平面成像 (SE EPI)T2 W序列对肝脏实性病变的检出能力。方法74例病人 (2 0 2个病灶 )接受肝脏 3种SE EPIT2 W序列磁共振扫描 ,评价其图像信噪比 (SNR)、肝脾对比噪声比 (L SCNR)、病灶对比噪声比 (CNR)及病变检出率 ,并与真实稳态进动快速成像 (true FISP)、快速自旋回波 (TSE)及半傅立叶采集单次激发快速自旋回波 (HASTE)等屏气T2 W序列相比较。结果SE EPI的SNR高于TSE (P <0 0 5 ) ,与true FISP相近 (P >0 0 5 ) ,但低于HASTE(P <0 0 1)。SE EPI序列的L SCNR及实性病变的CNR均显著高于true FISP、HASTE及TSE(P <0 0 1)。对于囊性病变 ,各序列间的检出率无明显差异 (P >0 0 5 )。各序列均检出所有直径大于 5cm的实性病变。直径 2～ 5cm的实性病变 ,SE EPI序列的检出率略高于true FISP、HASTE及TSE ,但无显著性差异 (P >0 0 5 )。直径小于 2cm的实性病灶 ,SE EPI序列的检出率 (93 9% )明显高于true FISP(5 7 6 % )、HASTE(71 2 % )及TSE(6 8 2 % ) (P <0 0 1)。结论　与其他屏气T2 W序列相比 ,SE EPIT2 WI有较高的病灶对比 ,能提高肝脏实性病变的检出率     

Uterine peristalsis: comparison of transvaginal ultrasound and two different sequences of cine MR imaging

PURPOSE: To compare uterine peristalsis as seen on two different magnetic resonance (MR) imaging sequences and transvaginal ultrasound (TVUS), so as to better determine the best method for evaluating uterine peristalsis. MATERIALS AND METHODS: Eleven women in the periovulatory phase of the menstrual cycle underwent TVUS and cine MR imaging within a time period of three hours. Findings on cine MR images obtained with a serial 60 half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequence and a 300 true fast imaging with steady-state precession (FISP) sequence were compared with TVUS. RESULTS: The image quality of the HASTE technique was the best among the three methods, followed by TVUS, and then true FISP technique (P < 0.001). Uterine peristalsis was detected in 100% of subjects using HASTE, 82% with True FISP, and 100% with TVUS. With HASTE technique, true FISP, and TVUS, respectively, endometrial stripping movement was identified in 100%, 82%, and 100%; direction was identified in 100%, 45% (P = 0.014), and 73%; and wave conduction toward the outer myometrium was identified in 55%, 9% (P = 0.025), and 0% (P = 0.014). CONCLUSION: Cine MR imaging by HASTE technique with a time resolution of two seconds best delineated uterine peristalsis compared to that by true FISP technique or with TVUS.