单次激发厚层投射磁共振胰胆管造影对胆系结石的诊断价值

目的探讨单次激发屏气重T2加权厚层快速自旋回波(SSTSE)磁共振胰胆管造影(MRCP)对胆系结石的诊断价值,并与其它传统无创性影像学检查方法(CT和B超)相对比。方法分析我院经临床证实的胆系结石患者78例。所有患者均进行了磁共振成像平扫、MRCP和B超检查,56人接受CT检查。回顾性分析所得影像资料,并对单纯厚层投射MRCP、厚层投射MRCP结合真实稳态进动(TrueFISP)T2WI、CT和B超诊断胆系结石的敏感性进行双盲法比较。应用计数资料的配对c2检验进行统计学处理。结果诊断肝外胆管结石,MRCP与CT、MRCP与B超之间的差异有非常显著意义(x2=8.10,15.06,P<0.01),MRCP结合T2WI与单纯MRCP之间的差异无显著性意义(x2=1.33,P>0.05);诊断胆囊结石,MRCP与CT之间的差异有显著性意义(x2=5.82,P<0.05),MRCP结合T2WI与CT的差异有非常显著意义(x2=9.09,P<0.01),而MRCP与B超的差异无显著性意义(x2=0.80,P>0.05)。结论SSTSEMRCP图像清晰,成像速度快,是一种诊断胆系结石安全简便、无创性的影像学检查方法。SSTSEMRCP诊断肝外胆管结石的效果优于B超和CT,诊断胆囊结石的效果优于CT。SSTSEMRCP与TrueFISPT2WI相结合,可提高胆系结石的检出率。

The diagnostic value of magnetic resonance cholangiopancreatography using single-shot projection and thick slice technique in biliary stone

Objective To probe into the diagnostic value of single-shot turbospin echo(SSTSE) breath-hold heavily T2 weighted Magnetic ResonanceCholangiopancreatography (MRCP) in biliary stone, and compare the resultswith those of CT and B mode ultrasound. Methods Seventy eight patients withbiliary stones were enrolled in this study and the diagnosis was confirmed withclinical data. All patients were examined by MRI, MRCP and B modeultrasound, of them, 56 patients were scanned with CT. The images of SSTSEMRCP, SSTSE MRCP+True FISP T2WI, ultrasound and CT were analysesdretrospectively, and the diagnostic sensitivity for biliary stone of every modalitywas compared with each other in a blind method. For statistical analysis,apaired McNemar x2 test was used for comparison between SSTSE MRCP, TrueFISP T2WI+SSTSE MRCP, CT and B mode ultrasound. Results Forextrahepatic duct stones, the difference of detectable rate between SSTSE-MRCPand CT or SSTSE-MRCP and B mode ultrasound was highly statisticallysignificant(x2=8.10,15.6, P<0.01);However, no statistically significantdifference was seen between the True FISP T2WI+SSTSE MRCP and SSTSEMRCP(x2=1.33,P>0.05). For gallbladder stones,the difference betweenMRCP and CT there was significant difference (x2=5.82,P<0.05), and thedifference between True FISP T2WI + SSTSE MRCP and CT there was verysignificant difference(x2=9.09,P<0.01). However, no significant differencewas seen between the MRCP and B mode ultrasound(x2=0.80,P>0.05).Conclusion SSTSE-MRCP with high quality of images and very fast imagingtime is a safe noninvasive imaging technique for diagnosis of biliary stone. Fordiagnosis of extrahepatic duct stone, SSTSE MRCP is superior to B modeultrasound and CT. However, for gallbladder stones, SSTSE MRCP is superiorto CT.SSTSE MRCP combined with True FISP T2WI can improve thedetectable rate of biliary stone.