核磁共振MRCP成像原理及成像技术
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摘要
目的分析核磁共振MRCP成像原理及成像技术。方法选取2016年6月～2018年6月50例医院收治的疑为胆管梗阻患者,所有患者均行磁共振胰胆管造影(MRCP)和内镜逆行胰胆管造影检查(ERCP),并以病理检查为标准,判断两种检查的诊断准确率,并记录两组患者检查并发症发生情况。结果 50例患者经病理组织检查均确诊为胆管梗阻,其中MRCP与ERCP的诊断准确率为94.0%和96.0%,差异无统计学意义;但ERCP并发症发生率明显高于MRCP(P <0.05)。结论 MRCP在胆管梗阻性疾病临床诊断中具有较高的应用价值,且能够避免内镜逆行胰胆管造影检查引起的并发症,具有较好的应用价值。
Objective To analyze the principle and technology of MRI MRCP imaging. Methods Fifty patients with suspected bile duct obstruction admitted to the hospital from June 2016 to June 2018 were performed MRI(MRCP)and ERCP examination(ERCP).Pathological examination was used as the standard to judge the diagnostic accuracy of the two kinds of examinations,and the incidence of examination complications in the two groups of patients was recorded.Results All the 50 patients were diagnosed with bile duct obstruction by pathological examination,and the diagnostic accuracies of MRCP and ERCP were 94.0% and 96.0%,with no statistical significance.However,the incidence of ERCP complications was significantly higher than that of MRCP(P < 0.05). Conclusion MRCP has a high application value in the clinical diagnosis of bile duct obstructive diseases,and can avoid the complications caused by endoscopic retrograde cholangiopancreatography,which has a good application value.
Objective To analyze the principle and technology of MRI MRCP imaging. Methods Fifty patients with suspected bile duct obstruction admitted to the hospital from June 2016 to June 2018 were performed MRI(MRCP)and ERCP examination(ERCP).Pathological examination was used as the standard to judge the diagnostic accuracy of the two kinds of examinations,and the incidence of examination complications in the two groups of patients was recorded.Results All the 50 patients were diagnosed with bile duct obstruction by pathological examination,and the diagnostic accuracies of MRCP and ERCP were 94.0% and 96.0%,with no statistical significance.However,the incidence of ERCP complications was significantly higher than that of MRCP(P < 0.05). Conclusion MRCP has a high application value in the clinical diagnosis of bile duct obstructive diseases,and can avoid the complications caused by endoscopic retrograde cholangiopancreatography,which has a good application value.
引文
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[11]Mensel,B.,Messner,P.,Mayerle,J. et al.Secretinstimulated MRCP in volunteers:Assessment of safety,duct visualization,and pancreatic exocrine function[J].AJR:American Journal of Roentgenology:Including Diagnostic Radiology,Radiation Oncology,Nuclear Medicine,Ultrasonography and Related Basic Sciences,2016,202(1):102-108.
[12]刘念,杨雄雄,黄小华,等.急性胰腺炎治疗前后胰胆管汇合夹角的MRCP研究[J].川北医学院学报,2017,32(4):525-528.
[13]MomtahenAJ,BalciNC,AlkaadeS,etal.Focal pancreatitis mimicking pancreatic mass:magnetic resonanceimaging(MRI)/magneticresonance cholangiopancreatography(MRCP)findings including diffusion-weighted MRI.[J].Acta Radiologica,2018,49(5):490-497.
[14]崔子林,朱志军,张雅敏,等.应用MRCP术前评估活体肝移植供者胆管系统[J].中华肝胆外科杂志,2016,16(6):418-421.
[15]王颖,徐荣天,李亚明,等.64排螺旋CT增强扫描胰胆管曲面成像与MRCP及MRI对胆道梗阻性疾病诊断的对比研究[J].中国临床医学影像杂志,2018,19(8):573-576.
[16]于华,卢福兴,朱明明,等.低场强MRCP对B超检查阴性的胆总管结石的诊断意义[J].海南医学院学报,2015,18(12):1820-1822.
[2]刘怡文,张学俭,王利群,等.MSCT、MRCP、ERCP对梗阻性黄疸病因诊断的对比分析[J].实用医学杂志,2015,21(19):2172-2173.
[3]余世耀,张弛,施诚仁,等.ERCP和MRCP在儿童胆胰疾病中的应用与评估[J].中华小儿外科杂志,2015,22(3):147-149.
[4]梅佳玮,赵铭宁,张文杰,等.ERCP在胰管损伤中的应用[J].中华肝脏外科手术学电子杂志,2016,5(6):376-379.
[5]McSweeney SE.,Kim TK,Jang HJ.et al.Biliary anatomy in potential right hepatic lobe living donor liver transplantation(LDLT):The utility of CT cholangiography in the setting of inconclusive MRCP[J].European Journal of Radiology,2015,81(1):6-12.
[6]张昊,白鲜玲,伊生勇,等.联合应用MRCP与ERCP对胆管疾病诊疗价值的研究[J].内蒙古医学杂志,2016,48(6):681-684.
[7]Wehrmann T,Eckardt AJ,Riphaus A.et al.Magnetic resonancecholangiopancreatography(MRCP)for suspected bilio-pancreatic disease:Should the endoscopist take a second look?[J].Zeitschrift Fur Gastroenterologie,2013,51(2):204-208.
[8]刘金成,米霞,李金凤,等.多层螺旋CT与低场磁共振胆管胰管成像技术在诊断胆道梗阻性疾病中的应用[J].实用临床医学,2016,13(6):85-86.
[9]Rosenkrantz AB,Block TK,Hindman N.et al.Combination of increased flip angle, radial k-space trajectory,and free breathing acquisition for improved detection of a biliary variant at living donor liver transplant evaluation using gadoxetic acid-enhanced MRCP[J].Journal of Computer Assisted Tomography,2016,38(2):277-280.
[10]蔡军.中度可疑胆总管结石行ERCP、MRCP及EUS的临床诊断价值对比分析[J].社区医学杂志,2016,14(9):66-67.
[11]Mensel,B.,Messner,P.,Mayerle,J. et al.Secretinstimulated MRCP in volunteers:Assessment of safety,duct visualization,and pancreatic exocrine function[J].AJR:American Journal of Roentgenology:Including Diagnostic Radiology,Radiation Oncology,Nuclear Medicine,Ultrasonography and Related Basic Sciences,2016,202(1):102-108.
[12]刘念,杨雄雄,黄小华,等.急性胰腺炎治疗前后胰胆管汇合夹角的MRCP研究[J].川北医学院学报,2017,32(4):525-528.
[13]MomtahenAJ,BalciNC,AlkaadeS,etal.Focal pancreatitis mimicking pancreatic mass:magnetic resonanceimaging(MRI)/magneticresonance cholangiopancreatography(MRCP)findings including diffusion-weighted MRI.[J].Acta Radiologica,2018,49(5):490-497.
[14]崔子林,朱志军,张雅敏,等.应用MRCP术前评估活体肝移植供者胆管系统[J].中华肝胆外科杂志,2016,16(6):418-421.
[15]王颖,徐荣天,李亚明,等.64排螺旋CT增强扫描胰胆管曲面成像与MRCP及MRI对胆道梗阻性疾病诊断的对比研究[J].中国临床医学影像杂志,2018,19(8):573-576.
[16]于华,卢福兴,朱明明,等.低场强MRCP对B超检查阴性的胆总管结石的诊断意义[J].海南医学院学报,2015,18(12):1820-1822.