低场磁共振胰胆管成像对诊断梗阻性黄疸的临床应用价值

目的:探讨利用低场磁共振仪进行胰胆管成像(M RCP)技术在诊断梗阻性黄疸中的临床应用价值。方法:利用0.2 T磁共振仪对34例梗阻性黄疸患者检查。先训练患者熟悉连续闭气26s或36s;腹部加压,常规SE序列横轴位T1W I、T2W I扫描及ST IR扫描,然后取轴位T2W I胆囊最大层面作M RCP定位,采用间隔快速激发射频脉冲序列行M RCP检查,图像经2D重建。结果:34例梗阻性黄疸,其中胆总管癌21例,胆总管结石10例,胆总管下段炎症3例均可显示胆道扩张,梗阻端形态轮廓钩划清楚,其良、恶性病变具有一定特征性表现,结合常规T1W I、T2W I图像,定位准确率100%(34/34),诊断符合率为91%(31/34)。所有病例均经一次扫描,基本能够满足诊断要求。结论:利用低场磁共振仪进行M RCP技术在诊断梗阻性黄疸病变中是一种无创伤检查技术,可显示梗阻部位,能较准确判断梗阻的病因、定位及定性,准确率高,具有一定的临床应用价值。

The clinical application of low field MRCP in the diagnosis of obstructive jaundice

Objective: To evaluate the clinical application of the magnetic resonance cholangiopancreatography(MRCP) in obstructive jaundice.Methods: 34 patients with obstructive jaundice were examined by 0.2T MRI.Before MRI examined firstly trained the patient familiar with continuing stop breathing for 26 seconds or 36 second;underwent a normal sequence of axial scan by T_1WI,T_2WI and STIR,then took the biggest level of the gall bladder by T_2WI in axial scan to make the MRCP positions,adopting the partition fast shot frequency pulse to perform MRCP examination and gained a 2D reconstructed image.Results: Among the 34 cases,there were 21 cases with common bile duct cancer,10 cases with common bile duct calculi,3 cases with lower part inflammation of common bile duct.All showed bile duct expansion,the obstruction carried a clear outline,benign and malignant pathological changes showed the certain characteristic,joining together the normal sequence T_1WI,T_2WI,locating accuracy rate 100%(34/34),diagnosing accuracy rate 91%(31/34).All cases scan once,basically satisfied the diagnosis request.Conclusion: Low field MRCP technique is a noninvasive method with certain clinical application value for diagnosis of the obstructive jaundice in the pathological changes,showing the part of obstruction,judging accurately the cause of obstruction,having a high rate of location and determination.