肝脏双功能对比剂Gd-BOPTA胆道成像临床初步研究

目的探讨肝脏双功能对比剂Gd-BOPTA应用于胆道成像的可行性及临床价值。方法应用GdBOPTA对15例患者（对照组10例,梗阻性黄疸组5例）进行胆道成像。比较胆系结构的显示（高信号对比剂充盈）率。测量计算肝脏和胆囊信号强度的变化值及其比值。结果对照组10例均能够显示胆总管、胆囊和肝总管,左右肝内胆管和胆囊管的显示率大于60%。梗阻性黄疸组1例于扩张胆总管内高信号胆汁对比下可见软组织信号充盈缺损。其余4例总胆红素大于131.4μmol/L,胆道未能显影。两组延迟扫描胆囊、肝脏信号强度变化及其比值差异有显著性（p=0.001,004,0.001）,对照组均高于梗阻性黄疸组。结论Gd-BOPTA在非梗阻性黄疸患者中可以得到较为满意的胆道二维及三维图像,为评价肝脏功能以及诊断或排除胆道病变提供了新的安全、无创检查手段。

Visualization of the Biliary Tract Using Gd-BOPTA:Pre-liminary Findings

Objective To evaluate the clinical value of Gd-BOPTA in contrast-enhanced magnetic resonance （MR） cholangiography for.visualization of the biliary systems. Methods Fifteen consecutive patients （10 with nondilated biliary tracts and 5 obstructive jaundice） who underwent MR imaging （MRI） of the liver were included in this retrospective study. Contrast-enhanced MR cholangiography was performed after intravenous administration of Gd-BOPTA. Superiority of visualization of biliary system was assessed. The signal changes of liver and gallbladder were measured. Resuits In nondilated biliary tracts group, all the bile common ducts, gallbladders and common hepatic ducts were visualized. More than 60% of the left and right intrahepatic bile ducts and cystic ducts were visualized. In obstructive jaundice group, a filling effect was visible on Contrast-enhanced MR cholangiography in one patients. However ,the biliary systems of the other four patients were not visualized, whose total bilirubin were larger than 131.4 μ mol/L. The changes of gallbladder and liver signal and its ratios were different significantly（p=0.001, 0.04, 0.001）, and those of the obstructive jaundice group were lower than the other group. Conclusion Gd-BOPTA can be used as an alternative intrabiliary contrast agent for contrast-enhanced MR cholangiography in nondilated biliary systems in patients with normal excretory liver function tests.