使用钆塞酸二钠增强磁共振胆胰管造影术检测胆囊切除术后胆管漏并定位：16例患者的回顾性研究
Detection and localization of bile duct leaks after cholecystectomy using Gd-EOB-DTPA-enhanced MR cholangiography: retrospective study of 16 patients.
作者信息
Ratcliffe Gregory E, Kirkpatrick Iain D, Anik Sahni V, Greenberg Howard M, Henderson Blair, Radulovic Dejana, Mottola Jeffrey C
机构信息
*From the Diagnostic Radiology, The Health Sciences Center, University of Manitoba, Winnipeg, Manitoba, Canada; †Diagnostic Radiology, MRI Department, St. Boniface General Hospital, University of Manitoba, Winnipeg, Manitoba, Canada; ‡Division of Abdominal Imaging and Intervention, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and §Diagnostic Radiology, CT Department, St. Boniface General Hospital, University of Manitoba, Winnipeg, Manitoba, Canada.
出版信息
J Comput Assist Tomogr. 2014 Jul-Aug;38(4):518-25. doi: 10.1097/RCT.0000000000000083.
OBJECTIVE
To determine if gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) cholangiography can detect and localize bile duct leaks in postcholecystectomy patients.
MATERIAL AND METHODS
Four blinded independent radiologists performed a retrospective review of 16 consecutive patients who underwent MR cholangiography with intravenous Gd-EOB-DTPA for the evaluation of possible biliary leak. Image quality, ductal opacification, and presence and location of any bile leak were evaluated. An independent observer determined the criterion standard using a consensus of all chart, clinical, and imaging findings.
RESULTS
All 6 bile leaks confirmed at endoscopic retrograde cholangiopancreatography were diagnosed by all reviewers (sensitivity, 100%). Of the 10 patients with no leak, only one reader incorrectly diagnosed a bile leak in a single case (specificity, 98%). The accuracy for detection of the site of leak with Gd-EOB-DTPA-enhanced MR cholangiography was 80%.
CONCLUSION
Gadolinium-EOB-DTPA-enhanced MR can detect bile leaks with a high sensitivity and specificity.
目的
确定钆塞酸二钠（Gd-EOB-DTPA）增强磁共振（MR）胆管造影能否检测并定位胆囊切除术后患者的胆管漏。
材料与方法
4名不知情的独立放射科医生对16例连续接受静脉注射Gd-EOB-DTPA进行MR胆管造影以评估可能的胆漏的患者进行回顾性研究。评估图像质量、胆管显影情况以及是否存在胆漏及其位置。一名独立观察者根据所有病历、临床和影像学检查结果的共识确定标准对照。
结果
所有在内镜逆行胰胆管造影中确诊的6例胆漏均被所有评估者诊断出来（敏感性为100%）。在10例无胆漏的患者中，只有一名观察者在1例中错误地诊断为胆漏（特异性为98%）。Gd-EOB-DTPA增强MR胆管造影检测漏出部位的准确率为80%。
结论
钆塞酸二钠增强MR能以高敏感性和特异性检测胆漏。
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