Safar F, Kamura T, Okamuto K, Sasai K, Gejyo F
Department of Radiology, Niigata University Faculty of Medicine, 1-757 Asahimachi-dori, 951-8510, Niigata, Japan.
Abdom Imaging. 2005 May-Jun;30(3):297-302. doi: 10.1007/s00261-004-0262-8.
We examined the role of magnetic resonance T1-weighted gradient-echo (MRT1-GE) imaging in hepatolithiasis.
MRT1-GE, precontrast computed tomography (CT), and magnetic resonance cholangiopancreatography (MRCP) of 10 patients with hepatolithiasis were compared for their diagnostic accuracies in the detection and localization of intrahepatic calculi. The diagnosis of hepatolithiasis was confirmed by surgery. For localization of the stone, we divided the bile ducts into six areas: right and left hepatic ducts and bile ducts of the lateral, medial, right anterior, and right posterior segments of the liver. Chemical analysis of the stones was performed in eight patients.
The total number of segments proved by surgery to contain stones was 18. Although not significantly different, the sensitivity of MRT1-GE was 77.8% (14 of 18 segments), higher than that of MRCP (66.7%, 12 of 18 segments) and that of CT (50%, nine of 18 segments). The sensitivity of magnetic resonance imaging (MRCP + MRT1) was significantly higher than that of CT (p < 0.01). Multiple logistic regression analysis showed that the result of surgery was significantly affected only by the result of magnetic resonance imaging. On MRT1-GE, all the depicted stones appeared as high-intensity signal areas within the low-intensity bile duct irrespective of their chemical composition.
MRT1-GE imaging provides complementary information concerning hepatolithiasis.
我们研究了磁共振T1加权梯度回波（MRT1-GE）成像在肝内胆管结石病中的作用。
比较了10例肝内胆管结石病患者的MRT1-GE、平扫计算机断层扫描（CT）和磁共振胰胆管造影（MRCP）在肝内结石检测和定位方面的诊断准确性。肝内胆管结石病的诊断经手术证实。为了结石定位，我们将胆管分为六个区域：左右肝管以及肝外侧、内侧、右前和右后段胆管。对8例患者的结石进行了化学分析。
手术证实有结石的节段总数为18个。虽然差异无统计学意义，但MRT1-GE的敏感性为77.8%（18个节段中的14个），高于MRCP（66.7%，18个节段中的12个）和CT（50%，18个节段中的9个）。磁共振成像（MRCP + MRT1）的敏感性显著高于CT（p < 0.01）。多元逻辑回归分析显示，手术结果仅受磁共振成像结果的显著影响。在MRT1-GE上，所有显示的结石在低信号强度的胆管内均表现为高信号强度区域，与结石的化学成分无关。
MRT1-GE成像为肝内胆管结石病提供了补充信息。
