磁共振肠道水成像在肠道常见疾病中的应用研究
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摘要
【目的】对甘露醇混合液和单纯2.5%甘露醇两种MRI肠道口服对比剂进行对比研究;探讨磁共振肠道水成像技术在肠道疾病中的应用及诊断价值。
【材料和方法】1对比剂的研究选择20例志愿者,分为A、B组,各10人,分别口服甘露醇混合液(每1000ml由20%甘露醇250ml,5%糖盐水500ml、水250ml所配成)和2.5%甘露醇两种对比剂,从扩张度、图像质量、不良反应方面对两组进行对照研究。2临床应用对临床拟诊有肠道病变的73例患者行MRI肠道检查,观察不同疾病的MRI表现,并评价各序列对病变的显示情况。
【结果】1对比剂的研究从小肠平均扩张度和不良反应方面对比,甘露醇混合液和单纯2.5%甘露醇两者无统计学意义(p＞0.05),从4、5、6组小肠的扩张度和图像质量方面对比,甘露醇混合液较2.5%甘露醇效果好,两者有统计学意义(p＜0.05)。用于肠道MRI检查的口服对比剂,混合液对远端肠管的扩张效果和图像质量优于2.5%甘露醇,是一种理想的对比剂。2临床应用73例患者中经手术病理证实45例,MRI诊断符合39例,准确率86.7%;余28例患者结合临床表现及其他相关检查,和MRI诊断符合有23例,符合率为82.1%。MRI各序列对病变的显示情况表明,对肿块的显示各序列没有差异;在显示肠壁改变、肠腔狭窄、肠外压迹和粘膜异常方面,差异存在显著性意义。
【结论】1.甘露醇混合液(每1000ml由20%甘露醇250ml,5%糖盐水500ml、水250ml所配成)作为肠道MRI检查的口服对比剂,能够增加肠腔信号,使肠腔、肠壁对比清晰,与周围组织形成对比,各组小肠及各段结肠充分充盈,且价格低廉,无明显副作用,因此可做为一种较为理想的MRI口服对比剂用于磁共振肠道检查的研究和临床应用。2.以甘露醇混合液作为口服对比剂,进行磁共振肠道水成像检查,能清晰显示小肠和大肠的肠壁、肠腔和肠周情况,可用于诊断肠道疾病。3.磁共振肠道水成像可应用于常见肠道疾病的定位、定性诊断,具有无创、无辐射、方便易行、诊断准确性高的优点,尤其对小肠疾病、肠道肿瘤性病变的判断,以及针对不宜行钡餐、胃肠镜的患者更具有优势。4.磁共振肠道水成像诊断肠道疾病,现处于研究阶段,还需要不断积累经验,进一步探索和研究。
[Objective]Comparative study of mixed solution and 2.5%osmotic mannitol as oral contrast medium of MRI inspection of intestine;Research the value of Magnetic resonance hydrography in application and diagnosis of intestinal disease.
[Materials and methods]1 Research of contrast medium 20 voluntees were derided into 2 groups,drunk mixed solution(every 1000ml solution consists of 20% osmotic mannitol 250ml、5%glucose saline 500ml and water 250ml)and 2.5% osmotic mannitol respectively.Compared the 2 groups infects from expantion degree, imaging quality and adverse reaction.2 Clinical application Seventy-three patiens with suspect of intestine disease were studied by MRI.Observed the MRI manifestations of the different disease.Evaluate the display effect of different MR sequences.
[Results]1 Research of contrast medium There were no significant difference between two groups in mean expantion degree and adverse reaction(p＞0.05),mixed solution was superior to 2.5%osmotic mannitol in expantion degree and imaging quality of the fourth、fifth、sixth group small intestine.As oral contrast medium of MRI inspection of intestine,mixed solution of osmotic mannitol was superior to 2.5% osmotic mannitol in expantion degree and imaging quality,was an ideal oral contrast medium.2 Clinical application In 73 patients,45 cases were pathologically proved. 39 cases' MRI diagnosis is correct,diagnostic accordance rate is 86.7%;In the last 28 cases,there are 23 cases' diagnosis accordance with clinical manifestation and other inspections,diagnostic accordance rate is 82.1%.There were no significant difference between different sequences of MRI in showing mass,but have difference in showing mural abnormalities,bowel constriction,extra-lumiinal compression and mucosal lesion.
[Conelution]1 Osmotic mannitol mixed solution as an oral contrast medium of MRI inspection of intestine,can enhance the sign of small intestinal tract,increase the contrast of the intestinal tract and the surrounding tissue,fully fill the enteric cavity, and low price,has no obvious adverse reaction,so it can be as an ideal oral contrast medium for Magnetic resonance hydrography in application and diagnosis of intestinal disease.2 Magnetic resonance hydrography using osmotic mannitol mixed solution as an oral contrast medium,can clear display small bowel and colorectal wall、enteric cavity and periphery structure.This method can be used in the diagnosis of intestinal disease.3 Magnetic resonance hydrography is valuable in localization diagnosis of intestinal disease,it has the advantages of non-invasive、non-ion radiation、convenient and high precision.Especially has advantages in the diagnosis of intestinal disease、intestinal tumor,and for the patients who unsuitable take the barium meal and gastroenterological endoscope.4 Magnetic resonance hydrography in a diagnosis of intestinal disease remains the research stage.The further experience should be accumulated and the effect observed.
【材料和方法】1对比剂的研究选择20例志愿者,分为A、B组,各10人,分别口服甘露醇混合液(每1000ml由20%甘露醇250ml,5%糖盐水500ml、水250ml所配成)和2.5%甘露醇两种对比剂,从扩张度、图像质量、不良反应方面对两组进行对照研究。2临床应用对临床拟诊有肠道病变的73例患者行MRI肠道检查,观察不同疾病的MRI表现,并评价各序列对病变的显示情况。
【结果】1对比剂的研究从小肠平均扩张度和不良反应方面对比,甘露醇混合液和单纯2.5%甘露醇两者无统计学意义(p＞0.05),从4、5、6组小肠的扩张度和图像质量方面对比,甘露醇混合液较2.5%甘露醇效果好,两者有统计学意义(p＜0.05)。用于肠道MRI检查的口服对比剂,混合液对远端肠管的扩张效果和图像质量优于2.5%甘露醇,是一种理想的对比剂。2临床应用73例患者中经手术病理证实45例,MRI诊断符合39例,准确率86.7%;余28例患者结合临床表现及其他相关检查,和MRI诊断符合有23例,符合率为82.1%。MRI各序列对病变的显示情况表明,对肿块的显示各序列没有差异;在显示肠壁改变、肠腔狭窄、肠外压迹和粘膜异常方面,差异存在显著性意义。
【结论】1.甘露醇混合液(每1000ml由20%甘露醇250ml,5%糖盐水500ml、水250ml所配成)作为肠道MRI检查的口服对比剂,能够增加肠腔信号,使肠腔、肠壁对比清晰,与周围组织形成对比,各组小肠及各段结肠充分充盈,且价格低廉,无明显副作用,因此可做为一种较为理想的MRI口服对比剂用于磁共振肠道检查的研究和临床应用。2.以甘露醇混合液作为口服对比剂,进行磁共振肠道水成像检查,能清晰显示小肠和大肠的肠壁、肠腔和肠周情况,可用于诊断肠道疾病。3.磁共振肠道水成像可应用于常见肠道疾病的定位、定性诊断,具有无创、无辐射、方便易行、诊断准确性高的优点,尤其对小肠疾病、肠道肿瘤性病变的判断,以及针对不宜行钡餐、胃肠镜的患者更具有优势。4.磁共振肠道水成像诊断肠道疾病,现处于研究阶段,还需要不断积累经验,进一步探索和研究。
[Objective]Comparative study of mixed solution and 2.5%osmotic mannitol as oral contrast medium of MRI inspection of intestine;Research the value of Magnetic resonance hydrography in application and diagnosis of intestinal disease.
[Materials and methods]1 Research of contrast medium 20 voluntees were derided into 2 groups,drunk mixed solution(every 1000ml solution consists of 20% osmotic mannitol 250ml、5%glucose saline 500ml and water 250ml)and 2.5% osmotic mannitol respectively.Compared the 2 groups infects from expantion degree, imaging quality and adverse reaction.2 Clinical application Seventy-three patiens with suspect of intestine disease were studied by MRI.Observed the MRI manifestations of the different disease.Evaluate the display effect of different MR sequences.
[Results]1 Research of contrast medium There were no significant difference between two groups in mean expantion degree and adverse reaction(p＞0.05),mixed solution was superior to 2.5%osmotic mannitol in expantion degree and imaging quality of the fourth、fifth、sixth group small intestine.As oral contrast medium of MRI inspection of intestine,mixed solution of osmotic mannitol was superior to 2.5% osmotic mannitol in expantion degree and imaging quality,was an ideal oral contrast medium.2 Clinical application In 73 patients,45 cases were pathologically proved. 39 cases' MRI diagnosis is correct,diagnostic accordance rate is 86.7%;In the last 28 cases,there are 23 cases' diagnosis accordance with clinical manifestation and other inspections,diagnostic accordance rate is 82.1%.There were no significant difference between different sequences of MRI in showing mass,but have difference in showing mural abnormalities,bowel constriction,extra-lumiinal compression and mucosal lesion.
[Conelution]1 Osmotic mannitol mixed solution as an oral contrast medium of MRI inspection of intestine,can enhance the sign of small intestinal tract,increase the contrast of the intestinal tract and the surrounding tissue,fully fill the enteric cavity, and low price,has no obvious adverse reaction,so it can be as an ideal oral contrast medium for Magnetic resonance hydrography in application and diagnosis of intestinal disease.2 Magnetic resonance hydrography using osmotic mannitol mixed solution as an oral contrast medium,can clear display small bowel and colorectal wall、enteric cavity and periphery structure.This method can be used in the diagnosis of intestinal disease.3 Magnetic resonance hydrography is valuable in localization diagnosis of intestinal disease,it has the advantages of non-invasive、non-ion radiation、convenient and high precision.Especially has advantages in the diagnosis of intestinal disease、intestinal tumor,and for the patients who unsuitable take the barium meal and gastroenterological endoscope.4 Magnetic resonance hydrography in a diagnosis of intestinal disease remains the research stage.The further experience should be accumulated and the effect observed.
引文
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[2]Giovagnoni A,Fabbri A,Marccioni F.Oral contrast agents in MRI of the gastrointestinal tract.Abdom Imaging,2002;27:367-375
[3]朱炯,许建荣,周艳等.小肠病变的MRI检查技术研究.放射学实践,2005,20(1):40-48
[4]李磊,朱炯,周艳,等.MRI诊断对小肠疾病的价值及其与小肠钡灌肠的比较[J]放射学实践,2006,21(1):92-95
[5]章士正,任小军,周合山.小肠磁共振水成像的诊断价值.中国计算机成像杂志,2003,9(6):421-425
[6]任小军,章士正.MR注气小肠灌肠及水成像对小肠疾病诊断价值的比较[J]放射学实践,2006,21(3):223-227
[7]Lee JKT,Marcos HB,Semelka RC.MR imaging of the small bowel using the HASTE sequence.AJR,1998,170:1457
[8]Free man AH,FRCR.CT and Bowel Disease[J].Br J Radiol,2001,74(1):4-14
[13]Umschaden HW,Szolar D,Gasser J,et al.Small-bowel Disease:Comparison of MR Enteroclysis Images with Conventional Enteroclysis and Surgical Findings[J].2000,215(3):717-725.
[9]Lomas DJ,Graves MJ.Small Bowel MRI using water as a Contrast Medium[J].Br J Radiol,1999,72(3):994-997
[10]Low RN,Francis IR.MR imaging of the gastrointestinal tract with Ⅳ gadolinium and diluted barium oral contrast media compared with unenhanced MR imaging and CT.AJR 1997;169:1051-1059
[11]Umschaden HW,Szolar D,Gasser J,et al.Small-bowel disease:comparison of MR enteroclysis imaging with conventional enteroclysis and surgical findings.Radiology 2000;215:717-725
[12]Maccioni F Kharrub Z,Buzzi G,et al.MRI in Crohn's disease:assessment of treatment response or relapse In:scientific Profram,the RSNA 87~(th)scientific assembly and annual meeting,Chicago.2001:254
[13]Oksendal AN,Jacobsen TF,Gundersen HG,Rinck PA,Rummeny E.Superparamagnetic particle as an oral contrast agent in abdominal magnetic-resonance-imaging.Investing Radiol,1991,26:s67-70
[14]Rieber A,Wruk D,Nussle K,et al.MRI of the abdomen combined with enteroelysis in Crohn disease using oral and intravenous Gd-DTPA.Radiologe 1998;38:23-28
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