Higashi Mayumi, Tanabe Masahiro, Ihara Kenichiro, Iida Etsushi, Furukawa Matakazu, Okada Munemasa, Ito Katsuyoshi
Department of Radiology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
J Magn Reson Imaging. 2021 Dec;54(6):1902-1911. doi: 10.1002/jmri.27775. Epub 2021 Jun 13.
The physiological flow patterns and the reciprocal relationship between pancreatic juice and bile excretion dynamics have not been clearly elucidated by imaging.
To assess the physiological flow patterns of bile and pancreatic juice simultaneously in order to clarify the pancreatobiliary flow dynamics using cine-dynamic magnetic resonance cholangiopancreatography (MRCP) with a spatial selective inversion recovery (IR) pulse.
Retrospective.
A total of 85 patients with physiologically normal pancreatobiliary flow without ductal dilatation (normal group) and 19 patients with dilated pancreatic duct.
FIELD STRENGTH/SEQUENCE: A 3 T, fast spin echo sequence with IR pulse to nullify the signal of static pancreatic juice and bile.
The frequency and secretion grade of the antegrade and reverse flow of the pancreatic juice and bile on cine-dynamic MRCP were visually evaluated. Additionally, the reciprocal relationship between pancreatic juice and bile flow was evaluated based on its flow patterns.
Spearman's rank correlation coefficient analysis and the Kruskal-Wallis and Mann-Whitney U tests were used. P values of <0.05 were considered to indicate statistical significance.
In the normal group, the antegrade pancreatic juice flow and no bile flow pattern was most frequently observed (29%), followed by the no pancreatic juice flow and no bile flow pattern (23%), the antegrade pancreatic juice flow and antegrade bile flow pattern (22%), and the no pancreatic juice flow and reverse bile flow pattern (9%). The flow of the pancreatic juice and bile were synchronized with each other in 47%, while they were not in 53%. In the dilated pancreatic duct group, the mean secretion grade of the antegrade bile and pancreatic juice flow was significantly lower than in the normal group.
Cine-dynamic MRCP with a spatially selective IR pulse can visualize the variations of the physiological flow patterns of bile and pancreatic juice including 53% of unsynchronized patterns.
4 TECHNICAL EFFICACY: Stage 5.
影像检查尚未清晰阐明胰液和胆汁排泄动力学的生理流动模式及其相互关系。
使用具有空间选择性反转恢复（IR）脉冲的电影动态磁共振胰胆管造影（MRCP）同时评估胆汁和胰液的生理流动模式，以阐明胰胆管流动动力学。
回顾性研究。
共有85例胰胆管生理流动正常且无导管扩张的患者（正常组）和19例胰管扩张患者。
场强/序列：3T，具有IR脉冲的快速自旋回波序列，用于消除静态胰液和胆汁的信号。
通过电影动态MRCP直观评估胰液和胆汁顺行和逆行流动的频率及分泌等级。此外，根据其流动模式评估胰液和胆汁流动之间的相互关系。
采用Spearman等级相关系数分析以及Kruskal-Wallis和Mann-Whitney U检验。P值<0.05被认为具有统计学意义。
在正常组中，最常观察到的是胰液顺行流动且无胆汁流动模式（29%），其次是无胰液流动且无胆汁流动模式（23%）、胰液顺行流动且胆汁顺行流动模式（22%）以及无胰液流动且胆汁逆行流动模式（9%）。胰液和胆汁的流动在47%的情况下相互同步，而在53%的情况下不同步。在胰管扩张组中，胆汁和胰液顺行流动的平均分泌等级显著低于正常组。
具有空间选择性IR脉冲的电影动态MRCP可以显示胆汁和胰液生理流动模式的变化，包括53%的不同步模式。
4 技术效能：5级
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