磁共振B-FFE序列在胆系疾病中的应用

目的 评价磁共振平衡全稳态快速场梯度回波（B-FFE）序列在胆系疾病诊断中的应用价值。资料与方法 104例胆系疾病息者术前行MRI检查,包括冠状位B-FFE,轴位T1WI／FFE、T2WI／TSE、T2WI／SPIR、磁共振胰胆管成像（MRCP）及动态增强,所有图像与手术病理结果对照。结果 B-FFE序列既可显示胆管病变,又可显示病变对周围结构的影响。B-FFE序列诊断胆系疾病准确率为90．4％,综合各种序列,MR总的诊断准确率为92．3％。结论 B-FFE序列能满意显示胰胆管系统,与MRCP和传统MRI相结合,可提高胆系疾病的诊断准确性。     

正常磁共振胰胆管造影原理的技术及表现

目的：分析磁共振胰胆管造影（MRCP）的正常表现及其对影像诊断的指导作用。材料和方法：对53例正常人进行MRCP检查,并行回顾性分析。MRCP采用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、三维（3D）成像及图像经最大信号强度投影（MIP）后处理。结果：检查的53例中,胆总管全部显影,胆总`上总管及左右肝管均显影者46例,胰管显影30例,正常胆总管管径不超过1．0cm,正常肝总管管径不超过0．9cm,正常左肝管管径不超过0．7cm,正常右肝管管径不超过0．6cm,正常胰管管径不超过0．2cm。结论 ：MRCP能显示正常人的胆胰管解剖结构,其正常管径的测量值对胰胆管影像诊断具有指导意义。     

肝吸虫性胆管炎的磁共振胰胆管成像诊断

目的 探讨磁共振胰胆管成像(MRCP)对肝吸虫性胆管炎的诊断价值。方法 使用3D-FASE(三维高级快速自旋回波)重T2加权扫描技术对54例肝吸虫性胆管炎患者进行MRCP检查，并对照内窥镜逆行性胰胆管造影(ERCP)、腹腔镜和手术病理结果。结果 本组54例肝吸虫性胆管炎的MRCP的定性诊断率为88．9％，主要表现为肝内胆管轻度扩张(46例)，末梢胆管囊状扩张(43例)，肝外胆管扩张(15例)和狭窄(19例)，胆总管及胆囊内充盈缺损性低信号(6例)。结论 采用3D FASE重T2WI序列能获得清晰的MRCP图像。肝吸虫性胆管炎的MRCP特征性表现为肝内胆管轻度扩张合并末梢胆管的小囊状扩张，MRCP是诊断肝吸虫性胆管炎较为理想的方法。     

2种方法磁共振胆胰管成像对胆系结石的诊断价值

磁共振胆胰管成像(m agnetic resonance cholangiopancreatog-raphy,MRCP)已广泛用于胆胰管疾病的评价,目前MRCP成像序列多采用重T2加权快速自旋回波(turbo sp in echo,TSE)序列和半傅立叶采集单次激发自旋回波序列(half-Fourier acqu i-sition single-shot turbo sp in-echo,HASTE)[1]。成像方法有单层面厚层采集(以下简称厚层法)和多层面薄层采集最大强度投影重建(m aximum intensity projection,M IP)(以下简称薄层法)2种[2]。厚层法多采用单次激发TSE序列(single shot TSE,SSTSE)[3,4],也可采用HASTE序列[2,5]。薄层法以…     

磁共振胰胆管成像对诊断胆胰系统疾病的临床应用价值

目的评价磁共振胰胆管成像(MRCP)技术在胆胰系统疾病诊断中的应用价值.方法68例患者进行了MRCP检查,其中正常对照组11例,各种胰胆管病变组57例.扫描使用ELSCINTSGR2.0T超导磁共振成像仪,体线圈及呼吸门控触发技术.平扫采用自旋回波(SE)常规成像;MRCP采用快速自旋回波(FSE)重T2加权像进行薄层扫描.所得图像用最大强度投影法(MIP)进行三维(3D)重建.结果MRCP能清晰显示胰胆管的解剖结构,对胆道梗阻程度和梗阻部位判断的确诊率达100%,梗阻原因的确诊率达91.2%.结论MRCP检查的成功率高,胰胆管解剖结构显示清晰,适应于各种胰胆管疾病的诊断,可作为该系统疾病诊断的首选方法     

胆系磁共振仿真内镜的临床应用评价

目的：评价磁共振仿真内镜（MRVE）对胆系梗阻性疾病的诊断价值。方法：47例胆系梗阻性病变的患者行MRVE检查。将快速自旋回波（FSE）和单次激发快速自旋回波（SSFSE）获得的二维T2WI数据传输至工作站，用导航软件显示胆管内腔。结果：MRVE清晰显示了胆管内解剖结构、梗阻部位和梗阻端的表面形态，FSE序列的MRVE和SS－FSE序列的MRVE对病变的定位准确率都为100％，检出病变的敏感性分别为92.2%和96.0%。结论：FSE序列的MRVE和SSFSE序列的MRVE都能显示胆系腔内结构。MRVE是对磁共振胆胰管造影（MRCP）技术的有益补充，但对胆系梗阻性病变诊断的特异性较性。     

肠道磁共振水成像诊断肠梗阻的应用价值

目的:探讨利用肠梗阻肠腔内的液体行磁共振水成像对肠梗阻的诊断价值。方法:35例肠梗阻患者行磁共振水成像检查。行半傅里叶采集单次激发快速自旋回波(HASTE)序列T2WI冠状面扫描,快速自旋回波(TSE)序列T2WI冠状面扫描,以及真稳态进动快速成像(True-FISP)序列冠状面和横断面扫描,快速小角度激发成像(FLASH)序列横断面和冠状面平扫和增强扫描。将诊断结果与手术、病理结果或临床诊断对照。结果:恶性梗阻9例,手术病理证实6例;粘连性肠梗阻15例,手术证实8例,梗阻平面定位准确6例;肠扭转3例,手术证实2例。结论:肠道磁共振水成像判断肠梗阻的部位、病因、程度、性质具有较高准确性,是诊断肠梗阻的一种可靠方法。     

胆胰管解剖:快速自旋回波单激发与重T2加权序列磁共振水成像对照研究

目的对比探讨快速自旋回波单激发(SS-FSE)与快速自旋回波重T2加权(HT2-FSE)序列磁共振水成像显示胆胰管解剖的价值.方法应用1.5T超导MR系统对58例患者行二维冠状面SS-FSE与HT2-FSE序列扫描.HT2-FSE源影像数据在工作站作MIP、SSD等后处理.结果SS-FSE和HT2-FSE对胆总管、肝总管、左右肝管及主要属支显示率均为100%;对胆囊显示率分别为89.1%和100%;对胰管显示率分别为91.4%和72.4%.对胆系和胰管梗阻扩张者,两种方法显示率一致,均达100%.在图像质量方面,显示胆系解剖HT2-FSE优于SS-FSE(Ρ＜0.01),显示胰管解剖SS-FSE优于HT2-FSE(Ρ＜0.01).结论胆胰管磁共振水成像宜常规应用HT2-FSE序列,重点观察胰管或患者难以承受磁共振长时检查时可采用SS-FSE序列.     

胆胰管解剖:快速自旋回波单激发与重T_2加权序列磁共振水成像对照研究

目的　对比探讨快速自旋回波单激发 (SS -FSE)与快速自旋回波重T2 加权 (HT2 -FSE)序列磁共振水成像显示胆胰管解剖的价值。方法　应用 1.5T超导MR系统对 5 8例患者行二维冠状面SS -FSE与HT2 -FSE序列扫描。HT2 -FSE源影像数据在工作站作MIP、SSD等后处理。结果　SS -FSE和HT2 -FSE对胆总管、肝总管、左右肝管及主要属支显示率均为 10 0 % ;对胆囊显示率分别为 89.1%和 10 0 % ;对胰管显示率分别为 91.4%和 72 .4%。对胆系和胰管梗阻扩张者 ,两种方法显示率一致 ,均达 10 0 %。在图像质量方面 ,显示胆系解剖HT2 -FSE优于SS -FSE(Ρ <0 .0 1) ,显示胰管解剖SS -FSE优于HT2 -FSE(Ρ <0 .0 1)。结论　胆胰管磁共振水成像宜常规应用HT2 -FSE序列 ,重点观察胰管或患者难以承受磁共振长时检查时可采用SS -FSE序列     

磁共振胰胆管成像技术的临床应用研究

目的：探讨磁共振胰胆管成像（MRCP）对胰、胆管疾病的诊断价值。方法：采用快速自旋回波（FSE）重T2加权技术对221例患进行了MRCP检查。结果：221例患中，MRCP正确诊断良性病变134例和恶性病变75例，定性诊断和定位诊断准确率分别为94．6％（209／221）和100％（221／221）。对良、恶性病变定性诊断准确率分别为96．4％（134／139）和91．4％（75／82）。结论:MRCP对胰、胆管疾病具有极高的诊断准确率，是一种颇有应用前景的影像技术。     

MR cholangiopancreatography: value of axial and coronal fast Spin-Echo fat-suppressed T2-weighted sequences

OBJECTIVE: To compare axial and coronal fast Spin-Echo fat-suppressed T2-weighted sequences with three-dimensional (3D) maximum intensity projection (MIP) images in patients with suspected pancreaticobiliary obstruction. MATERIAL AND METHODS: MR cholangiopancreatography (MRCP) was performed in 108 consecutive patients with a non-breath-hold, fat-suppressed, 2D, heavily T2-weighted fast spin-echo sequence in coronal plane. Axial T1- and T2-weighted images were previously obtained. In addition, 3D reconstructions of the coronal images were analysed separately by using a MIP algorithm. Both two-dimensional (2D) (axial and coronal) and 3D MIP images were separately evaluated by two readers in conference and their results were compared with that of endoscopic retrograde cholangiopancreatography, percutaneous trans-hepatic cholangiography, surgery and/or imaging follow-up. Statistical analysis of 2D and 3D MRCP images in diagnosing the level and probable cause of pancreaticobiliary obstruction were separately calculated. RESULTS: 106/108 of MRCP examinations were judged diagnostic by the two reviewers for adequacy of visualisation of the biliary and pancreatic ducts. Sensitivity, specificity, positive predictive value, negative predictive value and global diagnostic accuracy of 2D (axial and coronal) and 3D MRCP images in diagnosing the pancreaticobiliary obstruction were 94 and 57%,, 95 and 93%, 97 and 92%, 91 and 60%, 94 and 72% respectively. CONCLUSION: Our results do indicate a higher global accuracy for axial and coronal fast Spin-Echo fat-suppressed T2-weighted sequences versus 3D MIP images in diagnosis of the level and probable cause of pancreaticobiliary obstruction and stress the limitations of 3D images in depiction of small intraductal pathology such as calculi and biliary neoplastic.     

MRCP对梗阻性黄疸诊断价值的探讨

目的探讨磁共振胰胆管成像(MRCP)对梗阻性黄疸疾病的诊断价值。方法回顾性分析经手术或ERCP病理证实的梗阻性黄疸患者资料119例。该119例梗阻性黄疸患者用西门子1.5T超导型磁共振成像仪行常规MRI及MRCP检查。常规MRI包括轴位T1WI、T2WI及T2trufi冠状位扫描;MRCP检查包括3DMRCP和二维厚块MRCP检查。结果良性病变98例,其中胆系结石80例,胆管炎性狭窄12例,胆总管蛔虫4例,胆总管囊肿2例。恶性病变21例,其中胆管癌11例,壶腹癌3例,胰头癌7例。MRCP能清晰地显示正常胰胆管树结构,能直观地显示胰胆管扩张和梗阻的部位、形态、范围,对梗阻性胆道疾病的定位诊断准确率为100%,定性诊断准确率为94%。结论MRCP对梗阻性黄疸定位、定性诊断准确,特别是对结石的诊断,能清楚地显示梗阻部位、原因、病变形态、病变与周围结构的关系及周围病变性质,为临床手术方案提供可靠依据。     

MRCP对胆系梗阻性疾病的诊断及鉴别诊断研究

目的 探讨胆系梗阻性疾病的MRCP表现及其临床诊断价值.方法 对2002年12月至2004年12月共342例胆系梗阻性疾病进行MRCP检查,所有病例经手术病理或其他影像学和临床资料所证实.使用GE signa MRI/echo speed超导型1.5TMR扫描机,常规行上腹部T1WI和T2WI轴位扫描,MRCP采用单次激发快速自旋回波序列进行冠状位扫描.结果 342例胆系梗阻性疾病的定位诊断正确率为100%,结合常规平扫及其他影像学检查定性诊断正确率可达到92.4%.良性病变（包括胆管结石、胆总管囊肿及胆管炎性狭窄）140例,占所有病例的41%,诊断正确率达95.7%.医源性肝外胆管狭窄21例,占6%,诊断正确率达95.2%.恶性病变（包括胆管癌、胰头癌及壶腹癌）181例,占53%,诊断正确率达89.5%.结论 MRCP作为一种无创性检查手段,结合磁共振平扫和其他临床资料可对良性梗阻性病变及壶腹以上部位的恶性胆道梗阻做出较准确的定性、定位诊断;但对于壶腹周围梗阻性病变的准确诊断有待于进一步研究和改进.     

The callosal-septal interface lesion in multiple sclerosis: effect of sequence and imaging plane

We examined the effect of imaging plane and sequence on the demonstration of lesions at the callosalseptal interface (CSI) by magnetic resonance imaging in 20 patients with known multiple sclerosis. Variable-echo-(VE) T2- and proton density (PD) weighted images were performed in coronal axial and sagittal planes. Sagittal gradient echo (GE) T2- and PD-weighted images were also performed. Lesions at the CSI were seen in all patients and were all demonstrated on both sagittal and coronal VE images. Sagittal PD-weighted GE images were slightly less sensitive but showed good overall agreement with sagittal VE. Axial VE and sagittal T2-weighted GE images demonstrated CSI lesions poorly.     

Accuracy of T2-weighted fast spin-echo MR imaging with fat saturation in detecting cartilage defects in the knee: comparison with arthroscopy in 130 patients

OBJECTIVE: The purpose of this study was to assess the accuracy of routine T2-weighted MR imaging in detecting and grading articular cartilage lesions in the knee compared with arthroscopy. SUBJECTS AND METHODS: We examined 130 consecutive patients who underwent MR imaging and arthroscopy of the knee for suspected internal derangement. MR imaging consisted of axial and coronal T2-weighted fast spin-echo sequences with fat saturation and sagittal T2-weighted spin-echo sequences. Each single plane was evaluated and graded for the presence and appearance of articular cartilage defects using a standard arthroscopic grading scheme adapted to MR imaging. RESULTS: Of the 86 arthroscopically proven abnormalities, 81 were detected on MR imaging. Sensitivity of the T2-weighted fast spin-echo sequence with fat saturation was 61% for the coronal plane alone and 59% for the axial plane alone. Specificity for each plane was 99%. Sensitivity for the sagittal T2-weighted spin-echo sequence was 40%, and specificity was 100%. Sensitivity of the combination of axial and coronal T2-weighted fast spin-echo sequences with fat saturation and sagittal T2-weighted spin-echo sequence compared with arthroscopy for revealing cartilage lesions was 94%, specificity was 99%, and accuracy was 98%. Sensitivity of coronal and axial T2-weighted fast spin-echo sequences with fat saturation was 93%, and specificity was 99%. Fifty-five lesions (64%) were identically graded on MR imaging and arthroscopy. Seventy-eight lesions (90%) were within one grade using MR imaging and arthroscopy, and 84 lesions (97%) were within two grades using MR imaging and arthroscopy. CONCLUSION: T2-weighted fast spin-echo MR imaging with fat saturation is an accurate and fast technique for detecting and grading articular cartilage defects in the knee. The combination of the axial and coronal planes offers sufficient coverage of articular surfaces to provide a high sensitivity and specificity for chondral defects.     

磁共振胰胆管造影诊断胆管系统结石

目的：评价磁共振胰胆管造影在胆管系统结石中的诊断价值。材料和方法：对１００例胆管系统结石的患者进行了ＭＲＣＰ检查,采用不屏气快速自旋回波（ＦＳＥ）序列重Ｔ２加权成像,并用呼吸触发、脂肪抑制和最大信号强度投影（ＭＩＰ）的三维重建方法。对ＭＲＣＰ的诊断结果与手术或临床作了对照分析。结果：本组病例均获得了诊断质量的ＭＲＣＰ图像;１００例胆道结石的患者共有１５８处结石：肝内胆管结石２６例次,胆囊结石５６例次,总胆管结石７３例次和总肝管结石３例次。胆管系统结石的主要ＭＲＣＰ表现为：圆形或卵圆形信号缺失（充盈缺损）;倒杯口征;靶征;铸型样结石。ＭＲＣＰ结合原始图像对胆管系统结石诊断总检出率为９０％,而ＭＲＣＰ对胆管系统结石诊断部检出率为８２％两者比较（Ｐ〈０．０５）。结论：ＭＲＣＰ结合原始图像对胆管系统结石的诊断有较高的准     

Magnetic resonance imaging of anterior cruciate ligament tears: evaluation of standard orthogonal and tailored paracoronal images

PURPOSE: To evaluate the three standard orthogonal imaging planes and a paracoronal imaging plane for anterior cruciate ligament (ACL) tears. MATERIAL AND METHODS: Ninety patients (91 knees; 29 F and 61 M) aged between 15 and 84 years (mean 36.9 +/- 16.4 years) underwent magnetic resonance imaging (MRI) of the knee prior to arthroscopy. At surgery, 32 knees had an intact ACL, 4 a partial tear, and 55 a complete ACL tear. In all patients, axial, sagittal, coronal, and paracoronal T2-weighted turbo-SE images were acquired. The ACL was classified as intact, partially, or completely torn. Partial and complete tears were combined for statistical evaluation. RESULTS: Partial ACL tears (four cases) were not correctly diagnosed at MRI except in one knee by one observer on coronal images. Sensitivity in detecting ACL tears was 95%/63% (reader1/reader2) in the axial, 93%/95% in the sagittal, 93%/86% in the coronal, and 100%/93% in the paracoronal plane. Specificity was 75%/81% in the axial, 72%/81% in the sagittal, 78%/94% in the coronal, and 78%/88% in the paracoronal plane. CONCLUSION: ACL tears can be diagnosed accurately with each of the standard orthogonal planes. Based on reader confidence and interobserver agreement paracoronal images may be useful in equivocal cases.     

Magnetic resonance imaging gastrography: evaluation of the dark lumen technique compared with conventional gastroscopy in patients with malignant gastric disease

OBJECTIVES: We sought to demonstrate the feasibility of depicting gastric tumors using magnetic resonance imaging (MRI) while applying the dark lumen technique. The findings were correlated with conventional gastroscopy. In addition, we evaluated the screening for lymph nodes and liver metastases during the same session to identify potential tumor spread. MATERIALS AND METHODS: The study included 15 patients with known malignant gastric disease. Conventional gastrointestinal endoscopy was performed in all patients as gold standard. All patients were examined with computed tomography for tumor staging. MRI was performed using 1 L of tap water as oral contrast agent for all protocols. The MRI program included an axial T1-weighted (T1w; 2D-FLASH) sequence, an axial STIR and T2w (TSE) sequence, and 2 postcontrast T1w (3D coronal /2D axial FLASH) sequences using 0.2 mmol/kg gadolinium diethylenetriaminepenta-acetic acid as intravenously injected contrast agent. Qualitative analysis and comparison with conventional gastroscopy were performed. RESULTS: The images obtained with the postcontrast 3D coronal T1w-FLASH sequence were the most suitable in identifying gastric tumors. Complete correlation with conventional gastroscopy was achieved in 80% of the cases and partial correlation in 13% of the cases. The same imaging sequence was also appropriate for the evaluation of lymph nodes. For the identification of liver metastases, the images obtained with the axial postcontrast T1w 2D-FLASH sequence provided a higher diagnostic confidence as compared with other imaging protocols. CONCLUSIONS: Applying the dark lumen technique through MRI is suitable for imaging gastric tumors and has the potential to become a "one-stop shopping" method because of the possibility for lymph node evaluation and screening for metastases during the same session based on the same images.     

磁共振胆胰管成像显示胆囊罗-阿窦的影像病理对照分析

目的:探讨磁共振胰胆管成像(MRCP)显示胆囊罗-阿窦(RAS)的影像学表现及其病理特征.方法:45例胆囊腺肌增生症(GBA)患者,术前均行MRCP检查,常规采用单次激发FSE(SS-FSE)重T2WI序列和稳态采集快速成像(FIESTA)序列行冠状面扫描.将45例患者的MRCP表现和病理学资料进行对照,分析罗-阿窦的影像学特征及其病理基础.结果:45例中MRCP显示胆囊壁局限性变形、增厚43例,弥漫性增厚2例;增厚的胆囊壁内均见多个小囊状憩室样结构环状排列呈典型的"花环征",其内呈高信号.术后病理诊断为GBA并慢性胆囊炎45例,其中35例合并胆囊结石;罗-阿窦的病理表现为肌层内异位腺体,周围有增生的平滑肌组织环绕或伴神经纤维增生性改变.结论:MRCP可清晰显示GBA伴慢性胆囊炎患者胆囊壁罗-阿窦的形态特征,正确选择敏感无创的影像学检查方法和仔细观察罗-阿窦形态特征是GBA早期诊断和治疗的关键.     

腕关节的MR成像研究

目的探讨不同ＭＲ成像序列与方法在腕关节检查中的应用价值。材料与方法选取１６位健康志愿受试者的腕关节为研究对象,年龄２４～３５岁,对五种不同ＭＲ成像序列包括Ｔ。Ｗ１、ＰＤＷＩ、Ｔ２ＷＩ、ＳＴＩＲ和３Ｄ—ＧＥ及横断面、冠状面与矢状面三种成像平面进行研究。结果Ｔ１ＷＩ可以提供最佳解剖结构的细节,而Ｔ２ＷＩ可以很好地区分肿块、液体及软组织结构。ＳＴＩＲ成像有利于观察腕骨间韧带及三角纤维软骨（ＴＦＣ）结构。３Ｄ－ＧＥ成像可作连续薄层扫描,具有高信噪比、高分辨率、良好的组织对比及成像时间短等优点。横断面图像很好地显示腕管的结构;冠状面图像显示腕骨及腕骨间的相互关系、腕骨间韧带、ＴＦＣ及尺桡骨下端结构;矢状面图像可显示月骨、桡骨及头状骨间的相互关系及掌侧和背侧桡腕韧带。扫描时使用表面线圈,小ＦＯＶ,薄层可获得理想的ＭＲ图像。结论不同的ＭＲ序列及检查平面对腕关节不同组织的显示各具特异性。