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[多层螺旋CT与磁共振成像在胃肠道疾病中的应用]

[Multidetector CT and MRI in diseases of the gastrointestinal tract].

作者信息

Bruel J-M, Gallix B, Achard C, Pierredon M-A, Molina E

机构信息

Service de Radiologie, Hôpital Saint-Eloi, 34295 Montpellier Cedex 5.

出版信息

J Radiol. 2003 Apr;84(4 Pt 2):499-513; discussion 514-5.

Abstract

UNLABELLED

With the introduction of spiral scanning then multidetector technologies, the accuracy for diagnosing digestive tract diseases with CT has been highly improved, and CT is used more and more in the evaluation of patients with suspected gastrointestinal disorders. CT is able to demonstrate both the intramural and the extramural components of the disease, and has a major role in the preoperative staging and the follow-up. Improvements of CT protocols, such as CT-enteroclysis, or multiplanar 2D and 3D post-processing, including now techniques for "virtual endoscopy", lead to discuss new indications in which CT could now compete with conventional X-rays series and videoendoscopy. This precise study of the digestive wall, the peridigestive fat, the digestive tract blood supply, may be performed by MRI, under the condition of access to high level machines and standardized protocols. MR-enteroclysis and MR-virtual colonoscopy could be performed with much lower risk for the patient, in terms of radiation dose or contrast adverse effects. Endoluminal coils should give to MR an ultra-high resolution for analysing the different layers of the gastrointestinal wall.

LEARNING OBJECTIVES

to review how to perform CT and MRI protocols for digestive tract imaging, to recognize the CT and MR patterns of the main digestive tract diseases, to discuss the value, limits and role of CT and MR in digestive tract diseases, to discuss the potential role of CT and MR new technological developments for digestive tract imaging in the upcoming future.

CONCLUSION

CT is nowadays a modality of choice for digestive imaging. Improvements in technologies and indications, the necessary discussion of the risks and benefits for the patient should let the radiologists consider MRI in gastrointestinal disorders as an important part of the routine activity in clinical MRI.

摘要

未标注

随着螺旋扫描以及随后多探测器技术的引入,CT对消化道疾病的诊断准确性有了显著提高,并且在疑似胃肠道疾病患者的评估中使用得越来越多。CT能够显示疾病的壁内和壁外成分,在术前分期和随访中发挥着重要作用。CT检查方案的改进,如CT小肠造影,或多平面二维和三维后处理,包括现在的“虚拟内镜”技术,引发了关于CT在哪些新适应症方面可以与传统X线系列检查和视频内镜竞争的讨论。在能够使用高端设备和标准化检查方案的情况下,MRI可以对消化道壁、消化道周围脂肪、消化道血供进行精确研究。就辐射剂量或造影剂不良反应而言,患者接受MR小肠造影和MR虚拟结肠镜检查的风险要低得多。腔内线圈应能为MR提供超高分辨率,用于分析胃肠道壁的不同层次。

学习目标

回顾如何进行消化道成像的CT和MRI检查方案,识别主要消化道疾病的CT和MR表现,讨论CT和MR在消化道疾病中的价值、局限性和作用,讨论CT和MR新技术发展在未来消化道成像中的潜在作用。

结论

如今CT是消化道成像的首选方式。技术和适应症的改进,以及对患者风险和益处的必要讨论,应使放射科医生将MRI在胃肠道疾病中的应用视为临床MRI日常工作的重要组成部分。

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