屏气磁共振胆胰管成像的扫描技术探讨

目的　规范化屏气磁共振胆胰管成像 (MRCP)扫描方案。方法　 81个病例接受SS FSE序列MRCP扫描 ,结果进行盲法比较。结果　厚层投射MRCP对胆胰管的显示优于MIP法 ;MIP法 2D原始图像对小结石的显示率高于厚层投射MRCP及MIP重建MRCP ;无脂肪抑制 2D原始图像对腔外肿块的显示优于脂肪抑制 2D图像 ;斜冠状面MRCP能更好显示肝门区胆管及壶腹部。结论　MRCP应采用斜冠状面扫描 ;2D原始图像对腔内小病变及腔外肿块的显示非常重要 ;完整的MRCP应结合多种技术

Scanning Techniques in Breath-Hold MR Cholangiopancreatography

Objective To pursue standard scanning protocol of breath hold MR cholangiopancreatograpgy (MRCP). Methods With single shot turbo spin echo sequences, MR cholangiopancreatography was performed in 12 volunteers and 69 patients with different diseases of cholangiopancreas. Several techniques were compared in blind method. Results Bile ducts and pancreas ducts were showed more clearly in thick slab projection MRCP than in MIP MRCP ( P <0.01). MIP 2D raw images showed 91.7% of bile duct stone small than 5mm,while thick slab projection MRCP and MIP MRCP only showed 58.3% and 47.2% respectively ( P <0.01). 2D raw images without fat suppression showed 72.4% of masses, while 2D raw images with fat suppression only showed 44.8% ( P <0.05). The bifurcation of the left and the right hepatic duct was showed better on oblique coronal MRCP than on coronal MRCP ( P <0.05). Conclusion Oblique coronal MRCP can show cholangiopancreas ducts better than coronal MRCP. MIP 2D raw image is very important for detecting small lesions in the ducts. 2D raw image without fat suppression is needed for detecting mass outside the ducts. Comprehensive MRCP should include several MRCP techniques and conventional MRI.