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磁共振虚拟胆道镜检查的临床应用价值
引用本文:王永坤,常时新,朱江帆,汪波,宗根林,王轶彬. 磁共振虚拟胆道镜检查的临床应用价值[J]. 中国微创外科杂志, 2010, 10(7): 608-611
作者姓名:王永坤  常时新  朱江帆  汪波  宗根林  王轶彬
作者单位:同济大学附属东方医院微创外科,上海,200120
摘    要:目的探讨磁共振虚拟胆道镜(magnetic resonance virtual cholangiography,MRVC)诊断胆道系统病变的临床应用价值。方法用3.0T磁共振仪对87例胆道疾病患者行3D快速自旋回波胆胰管水成像(3D-TSE-MRCP)检查,用随机配备的虚拟内镜软件对检查资料进行3D重建,形成虚拟胆道镜视频资料。以术中所见、病理检查及ERCP+EST取石术明确诊断,计算胆囊、胆管结石MRVC的敏感性、特异性、阳性和阴性预测值。例数较少病例结合临床相关资料对MRVC视频图像进行具体分析。结果 MRVC诊断胆囊结石敏感性、特异性、阳性和阴性预测值分别为71.8%(51/71)、75.0%(6/8)、96.2%(51/53)和23.1%(6/26),胆管结石的上述指标分别为87.5%(28/32)、98.2%(54/55)、96.6%(28/29)和93.1%(54/58)。结论虚拟胆道镜具有直观形象、无创伤、可重复等独特优越性,是对2D成像技术和传统纤维内镜的良好补充。

关 键 词:磁共振  虚拟胆道镜  胆道疾病

Value of Virtual Magnetic Resonance Cholangiography in Clinical Practice
Affiliation:Wang Yongkun,Chang Shixin,Zhu Jiangfan,et al. (Department of Minimally Invasive Surgery,East Hospital,Tongji University,Shanghai 200120,China)
Abstract:Objective To evaluate the value of virtual magnetic resonance cholangiography (VMRC) in diagnosing biliary diseases. Methods A total of 87 patients with biliary diseases underwent 3 dimensional turbo spin echo MR cholangiopancreatography (3D-TSE-MRCP) by 3.0T MR imaging. The raw data were sent to the auxiliary workstation and post-processed by VMRC to reconstruct 3D video data. The diagnosis of the patients were made by observation during operation,pathology and ERCP+EST. The sensitivity,specificity,positive and negative predicative values of virtual VMRC for gallstone and bile duct stones were calculated. In a few cases,VMRC video data were analyzed together with clinical data. Results The sensitivity,specificity,positive and negative predictive values of VMRC for gallstones were 71.8% (51/71),75.0% (6/8),96.2% (51/53),and 23.1% (6/26),respectively. While those for bile duct calculi were 87.5% (28/32),98.2% (54/55),96.6% (28/29),and 93.1% (54/58). Conclusions VMRC has advantages in direct surgical view,non-invasion and repeatability. It can be an alternative to 2D imaging and fiberoptic endoscope.
Keywords:Magnetic resonance  Virtual cholangiography  Biliary diseases
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