口服枸橼酸铁铵泡腾颗粒在MRCP检查中定位胆结石的应用

目的分析口服枸橼酸铁铵泡腾颗粒在磁共振胆胰管成像(MRCP)检查中对影像质量、胆结石检出率的影响及对临床胆结石手术的指导价值。方法共收集2014年10月—12月68例胆道系统结石病变病人资料,均行常规MRCP检查,口服枸橼酸铁铵泡腾颗粒30 min后再行MRCP检查,2位高年资影像诊断医生分别对服药前后影像质量进行评分,用Kappa检验分析评价双盲法MRCP影像质量评分的一致性。以手术结果为金标准,对照口服枸橼酸铁铵泡腾颗粒30 min前后MRCP检查定位胆结石的准确率,采用χ2检验对胆结石检出率进行分析。结果口服枸橼酸铁铵泡腾颗粒30 min后行MRCP检查较服药前MRCP影像评分明显提高,且2位高年资影像诊断医生影像质量评分的一致性良好(P0.05)。服药后对肝管、胆囊、胆总管上段和中段部位的结石的检出率均高于服药前(均P0.05),但胆总管下段结石显示较差(P0.05)。结论口服枸橼酸铁铵泡腾颗粒对胰胆树解剖和病变的显示更清晰,提高影像质量,提高胆道系统结石定位的准确性,对临床手术定位具有重要的指导价值。

Application of oral ferric ammonium citrate effervescent granules in positioning of gallstones in MRCP examination

Objebtive By comparing the images of magnetic resonance cholangiopancreatography (MRCP) examination before and after oral administration of ferric ammonium citrate effervescent granules, to study the influences of the drug on the image quality, gallstone detection rate and clinical gallstone surgery. Methods The data of 68 patients with biliary system lithiasis receiving treatment at our hospital between October 2014 and December 2014 were collected. All the patients were subjected to routine MRCP examination, oral administration of ferric ammonium citrate effervescent granules, and MRCP examination 30 mins after the drug administration. Two senior radiologists were blinded to each other to conduct image quality scoring before and after the drug administration. Kappa test analysis was used to evaluate the consistency of the MRCP image quality score by the two radiologists. Taken surgical results as the gold standard, comparison of the accuracy rate in locating gallstones with MRCP examination before and after 3D minutes took ferric ammonium citrate effervescent granules orally. Furthermore, Chisquare test was used in analysing the detection rate of gallstones. Results The quality scores 30 mins after orally taking the ferric ammonium citrate effervescent granules were significantly improved compared with the quality scores before taking the drug;and the consistency of the image quality scoring between the two radiologists was good ( P<0 . 05 ) . The gallstone detection rates at hepatic duct , gallbladder, and upper and middle parts of common bile duct were all higher than those of before medication (all P<0.05). However, the gallstone detection rate in the lower part of common bile duct after medication did not significantly differ from the rate before medication (P>0.05). Conclusion Oral administration of the ferric ammonium citrate effervescent granules enables the pancreatic biliary tube anatomy and lesions to be showed more clearly, improves image quality and the accuracy of the gallstone positioning of biliary system, and has an important guiding significance on clinical surgery positioning.