Department of Radiology, Thomas Jefferson University, Philadelphia, USA.
Dig Dis Sci. 2018 May;63(5):1102-1122. doi: 10.1007/s10620-018-4991-x.
MRI has transformed from the theoretical, investigative realm to mainstream clinical medicine over the past four decades and has become a core component of the diagnostic toolbox in the practice of gastroenterology (GI). Its success is attributable to exquisite contrast and the ability to isolate specific proton species through the use of different pulse sequences (i.e., T1-weighted, T2-weighted, diffusion-weighted) and exploiting extracellular and hepatobiliary contrast agents. Consequently, MRI has gained preeminence in various GI clinical applications: liver and pancreatic lesion evaluation and detection, liver transplantation evaluation, pancreatitis evaluation, Crohn's disease evaluation (using MR enterography) rectal cancer staging and perianal fistula evaluation. MR elastography, in concert with technical innovations allowing for fat and iron quantification, provides a noninvasive approach, or "MRI virtual liver biopsy" for diagnosis and management of chronic liver diseases. In the future, the arrival of ultra-high-field MR systems (7 T) and the ability to perform magnetic resonance spectroscopy in the abdomen promise even greater diagnostic insight into chronic liver disease.
MRI 在过去的四十年里已经从理论、研究领域转变为主流临床医学，并成为胃肠病学（GI）诊断工具的核心组成部分。它的成功归因于其出色的对比度以及通过使用不同的脉冲序列（即 T1 加权、T2 加权、扩散加权）和利用细胞外和肝胆对比剂来分离特定质子种类的能力。因此，MRI 在各种 GI 临床应用中占据了优势地位：肝脏和胰腺病变的评估和检测、肝移植评估、胰腺炎评估、克罗恩病的评估（使用磁共振肠造影术）、直肠癌分期和肛周瘘管评估。磁共振弹性成像与允许定量脂肪和铁的技术创新相结合，为慢性肝病的诊断和管理提供了一种非侵入性的方法，即“MRI 虚拟肝活检”。未来，超高场强 MRI 系统（7T）的出现以及在腹部进行磁共振波谱分析的能力有望为慢性肝病提供更深入的诊断见解。
