Masui T, Takehara Y, Ichijo K, Naito M, Watahiki H, Kaneko M, Nozaki A, Sun Y
Department of Radiology, Seirei Mikatabara General Hospital, Hamamatsu, Shizuoka, Japan.
AJR Am J Roentgenol. 1999 Dec;173(6):1519-26. doi: 10.2214/ajr.173.6.10584795.
The purpose of this study was to assess abilities of single thick-slice MR cholangiopancreatography and multiple thin-slice multiprojection volume reconstruction (MPVR) MR cholangiopancreatography to evaluate diseases in and around the pancreas.
Eighty-nine patients underwent both single and MPVR MR cholangiopancreatography using a single-shot fast spin-echo technique. Image quality (five-point scale), visualization of the common bile and pancreatic ducts (three-point scale), stenotic, dilatational, or cystic changes of the pancreatic ducts, and other pathologic findings were evaluated.
Image quality was high for single and MPVR MR cholangiopancreatography (4.1+/-0.7 and 4.5+/-0.6, respectively). Misregistration was noted in 19 patients with MPVR MR cholangiopancreatography. Ducts on and around the greater duodenal papilla and the common bile duct were revealed better using MPVR than single MR cholangiopancreatography (p < .05). Overall sensitivity, specificity, and accuracy for detection of stenosis of the main pancreatic ducts were 83.3%, 93.6%, and 88.8%, respectively, using single MR cholangiopancreatography and 76.2%, 97.9%, 87.6%, respectively, using MPVR MR cholangiopancreatography. Dilatation of the pancreatic ducts (100%) and cystic changes (n = 17 and n = 19, respectively) were well seen using either single or MPVR MR cholangiopancreatography. Although stenotic changes of the nondilated main pancreatic ducts and their branches were difficult to evaluate using single (62.5% and 14.3%, respectively) or MPVR (43.8% and 21.4%, respectively) MR cholangiopancreatography, single MR cholangiopancreatography better depicted ductal continuity.
For evaluation of the pancreas, single and MPVR MR cholangiopancreatography provide complementary data; thus, we recommend using a combination of these two MR cholangiopancreatography techniques.
本研究旨在评估单层厚片磁共振胰胆管造影(MRCP)及多层薄片多平面容积重建(MPVR)MRCP评估胰腺及其周围疾病的能力。
89例患者采用单次激发快速自旋回波技术分别接受单层厚片及MPVR MRCP检查。评估图像质量(五分制)、肝总管及胰管的显示情况(三分制)、胰管的狭窄、扩张或囊性改变以及其他病理表现。
单层厚片及MPVR MRCP的图像质量均较高(分别为4.1±0.7和4.5±0.6)。19例接受MPVR MRCP检查的患者出现配准不良。MPVR显示十二指肠大乳头及其周围和肝总管的情况优于单层厚片MRCP(p<0.05)。单层厚片MRCP检测主胰管狭窄的总体敏感性、特异性和准确性分别为83.3%、93.6%和88.8%,MPVR MRCP分别为76.2%、97.9%和87.6%。单层厚片或MPVR MRCP均能很好地显示胰管扩张(100%)和囊性改变(分别为17例和19例)。尽管单层厚片(分别为62.5%和14.3%)或MPVR(分别为43.8%和21.4%)MRCP难以评估未扩张的主胰管及其分支的狭窄改变,但单层厚片MRCP能更好地显示导管连续性。
对于胰腺评估,单层厚片及MPVR MRCP可提供互补数据;因此,我们建议联合使用这两种MRCP技术。