磁共振成像2D-FIESTA序列对婴幼儿胆道病变的诊断价值

目的评价磁共振成像2D-FIESTA序列对婴幼儿胆道病变的诊断价值。方法8例婴幼儿患者行MR检查胆道系统。患儿口服水合氯醛或静注安定镇静。行轴位、冠状和矢状2D-FIESTA扫描。不需屏气。不使用MR对比剂。在ADW工作站上以最大强度投影(M IP)和多平面重建(MPR)方式重建图像。结果3例肝移植术后、2例胆总管囊肿、1例胆胰管合流异常患儿的MR I表现均经手术证实,2例正常婴幼儿经随访证实。MR I的2D-FIESTA序列可清晰显示患儿的肝外胆管及门静脉、肝静脉和下腔静脉,肝动脉显示欠清晰。结论MR I的2D-FIESTA序列可在自由呼吸、不使用对比剂的条件下准确显示婴幼儿的胆道系统病变。

2D-FIESTA Sequence of MRI in the Evaluation of the Biliary Tract for the Infants and Young Children

Objective To evaluate the diagnostic value of 2D-FIESTA sequence of MRI in the detection of the biliary tract lesions in infant and young children patients(less than 3 years).Methods 8 infant and young children patients were examined by MRI to evaluatetheir biliary tract.Images were obtained with a 1.5T whole body MRI system(GE Medical System,Milwakee,Wis,USA),using theCARDIAC coil.The patients were sedated by chloral hydrate orally or by pentobarbital sodium intravenously.No contrast agents wererequired.All of the axial,coronal and sagittal images were reviewed on an independent workstation and maximum intensity projection(MIP) and multiplanar reformations(MPR) techniques were applied.Results The 2D-FIESTA pulse sequence results in images in which the hepatic vascular structures and the biliary tract were highlighted.In this way,a clear visualization of the hepatic vessels and biliarytract could be obtained in all 8 cases.MRI could demonstrate the anatomy and pathology of post-transplantation changes in 3 patients,choledochal cysts in 2 patients,anomalous connection between the bile and pancreatic ducts in 1 patient.All the abnormalities were proved by operation.2 examinees were diagnosed normal by MRI and were confirmed by follow-up.Conclusion 2D-FIESTA is a fast sequence that allows the high quality images to be generated without breath-hold and without administration of contrast material.It has a potential wide application in the evaluation of biliary tract in the infant patients.