Takahashi Toshiyuki, Kato Kyoichi, Nishizawa Takeshi, Nakazawa Yasuo
Department of Radiology, Showa University Fujigaoka Hospital.
Nihon Hoshasen Gijutsu Gakkai Zasshi. 2008 May 20;64(5):573-8. doi: 10.6009/jjrt.64.573.
The clinical usefulness, as well as the advantages and limitations of DWI in the abdomen and pelvis, currently are under discussion. One of the limitations is the artifact from bowel fluid that may obscure lesion signals or make it difficult to detect them. The purpose of this study was to examine evidence as to whether an oral contrast agent of ferric ammonium citrate could eliminate this artifact from the bowel loop. The study consisted of a phantom study and clinical study. The density of the phantom compounded it to 1-6 times, 8 times and 12 times. We changed the density with ferric ammonium citrate to find the best density. The pulse sequence used SE-PEI and, variable parameter changed TE and b value. The signal intensity of the phantoms was visually analyzed. We took the results to an outside observer as a clinical study and confirmed the effect visually. When a signal of ferric ammonium citrate extended TE time and increased b value, it fell. As it thickened the density of phantom, it was the result that the signal deteriorated, and was good. However, an artifact from ferric ammonium citrate appeared when we exceeded 5x density. The signal of the bowel fluid artifact disappeared by having a normal person take the 4x density as in the clinical study. Elimination of bowel fluid artifact on abdominal DWI was able to suggest the possibility of taking the ferric ammonium citrate solution at 4x density.
目前,弥散加权成像(DWI)在腹部和盆腔的临床实用性以及优缺点仍在讨论中。其中一个局限性是肠液产生的伪影,它可能会掩盖病变信号或使其难以被检测到。本研究的目的是检验柠檬酸铁铵口服造影剂是否能够消除肠袢产生的这种伪影。该研究包括一个模型研究和临床研究。模型的密度设置为1 - 6倍、8倍和12倍。我们通过改变柠檬酸铁铵的密度来寻找最佳密度。使用的脉冲序列为SE - PEI,可变参数为TE和b值。对模型的信号强度进行视觉分析。我们将结果作为临床研究展示给外部观察者,并通过视觉确认效果。当柠檬酸铁铵的信号延长TE时间并增加b值时,信号强度下降。随着模型密度增加,信号变差,但效果良好。然而,当密度超过5倍时,出现了柠檬酸铁铵产生的伪影。在临床研究中,让正常人服用4倍密度的溶液后,肠液伪影的信号消失了。腹部DWI上肠液伪影的消除表明服用4倍密度柠檬酸铁铵溶液具有可行性。