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磁共振胆系成像在潜在肝脏供者中的应用:口服泡腾剂给药后的定量和定性改善。

MR cholangiography in potential liver donors: quantitative and qualitative improvement with administration of an oral effervescent agent.

机构信息

Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Department of Radiology and the Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

出版信息

J Magn Reson Imaging. 2017 Dec;46(6):1656-1663. doi: 10.1002/jmri.25715. Epub 2017 Mar 23.

Abstract

PURPOSE

To determine whether an oral effervescent agent improves magnetic resonance cholangiography (MRC) images, both qualitatively and quantitatively, in potential live liver donors.

MATERIALS AND METHODS

This retrospective study was approved by the Institutional Review Board, and informed consent was waived. Seventy potential liver donors underwent 2D MRC before and after administration of an oral effervescent agent. One radiologist measured relative contrast ratio (rC) and relative signal intensity (rS) for right and left intrahepatic ducts (RHD and LHD), and common hepatic duct (CHD). After assessment of overall image quality, two other radiologists independently scored visualization of five ductal segments (RHD, LHD, CHD, cystic, and common bile duct) and assessed the preferred image set. In consensus, they assessed the biliary anatomy. The data were analyzed using a paired t-test, Wilcoxon's signed-rank test, and chi-square test.

RESULTS

Both rC and rS of RHD and CHD were significantly higher on MRC images after administration of an oral effervescent agent than before (P < 0.03). The overall image quality grades and biliary visualization scores for all five duct segments were significantly higher on MRC images after administration of an oral effervescent agent than before (P < 0.0001). Between these images, both readers more often preferred MRC images with an effervescent agent rather than those without this agent (reader 1: 56/70, 80.0%; reader 2: 55/70, 78.6%; P = 0.0003). The readers correctly assessed second-order biliary tract anatomy in two more subjects on MRC after administration of an effervescent agent than before.

CONCLUSION

Oral administration of an effervescent agent improves MRC images, both qualitatively and quantitatively, in live liver donors.

LEVEL OF EVIDENCE

3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1656-1663.

摘要

目的

在潜在活体肝供者中,确定口服泡腾剂是否能改善磁共振胆胰管成像(MRCP)的图像质量,包括定性和定量两方面。

材料与方法

本回顾性研究经机构审查委员会批准,且豁免了知情同意。70 例潜在肝供者在口服泡腾剂前后行二维 MRCP。一位放射科医师测量右肝内胆管(RHD)和左肝内胆管(LHD)以及肝总管(CHD)的相对对比比(rC)和相对信号强度(rS)。在评估整体图像质量后,另外两位放射科医师独立对 5 个胆管段(RHD、LHD、CHD、胆囊和胆总管)的可视化程度进行评分,并评估首选图像集。在达成共识的基础上,他们评估了胆道解剖结构。使用配对 t 检验、Wilcoxon 符号秩检验和卡方检验对数据进行分析。

结果

口服泡腾剂后 RHD 和 CHD 的 rC 和 rS 均明显高于用药前(P<0.03)。口服泡腾剂后,所有 5 个胆管段的整体图像质量评分和胆道可视化评分均明显高于用药前(P<0.0001)。在这些图像中,两位读者都更倾向于选择有泡腾剂的 MRCP 图像,而不是没有泡腾剂的图像(读者 1:56/70,80.0%;读者 2:55/70,78.6%;P=0.0003)。与用药前相比,两位读者在口服泡腾剂后能更正确地评估 2 级胆道解剖结构,多出 2 例。

结论

口服泡腾剂可改善活体肝供者的 MRCP 图像质量,包括定性和定量两方面。

证据水平

3 级 技术效果:第 2 阶段 J. 磁共振成像 2017;46:1656-1663。

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