Regan F, Fradin J, Khazan R, Bohlman M, Magnuson T
Department of Imaging, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
AJR Am J Roentgenol. 1996 Dec;167(6):1441-5. doi: 10.2214/ajr.167.6.8956574.
We performed this study to evaluate the usefulness of a new T2-weighted MR sequence using a half-Fourier acquisition single-shot turbo spin-echo (HASTE) technique in the diagnosis of bile duct stones.
We prospectively evaluated 23 patients with suspected bile duct calculi using HASTE MR cholangiography and compared that imaging technique with endoscopic retrograde cholangiography and sonography. The study group consisted of 15 women and eight men who were 42-89 years old. Patients were imaged in the axial, coronal, and sagittal planes with a 1.5-T MR scanner using a body coil. Acquisitions of 13 sec each allowed images to be obtained in a single breath-hold. All images were interpreted by two radiologists in a double-blinded fashion. The presence, number, and size of stones were noted, and common bile duct dilatation was assessed.
Fifteen of the 23 patients were proven to have common bile duct stones. Stone size ranged from 3 mm to 35 mm (mean, 11 mm). HASTE MR cholangiography revealed stones in 14 (93%) of 15 patients; sonography revealed stones in nine (60%) of 15 patients. In 12 patients, the common bile duct was dilated, as shown by endoscopic retrograde cholangiography, HASTE MR cholangiography, and sonography. On HASTE MR cholangiograms, we measured the diameter of the bile duct in all patients. The mean diameter was 11 mm, which correlated well (r = .82) with a mean diameter of 13.5 mm as measured on endoscopic retrograde cholangiograms.
HASTE MR cholangiography can noninvasively and rapidly reveal the presence of stones in the common bile duct and allows readers to assess the degree of biliary dilatation. The sequence should be considered as an alternative to endoscopic retrograde cholangiography in patients with clinical evidence of bile duct calculi and in those for whom endoscopic retrograde cholangiography is impossible.
我们开展本研究以评估采用半傅里叶采集单次激发快速自旋回波（HASTE）技术的新型T2加权磁共振序列在胆管结石诊断中的效用。
我们前瞻性地采用HASTE磁共振胆胰管造影术评估了23例疑似胆管结石患者，并将该成像技术与内镜逆行胆胰管造影术及超声检查进行比较。研究组包括15名女性和8名男性，年龄在42至89岁之间。使用体线圈在1.5-T磁共振扫描仪上对患者进行轴位、冠状位和矢状位成像。每次采集13秒，可在一次屏气过程中获取图像。所有图像均由两名放射科医生采用双盲方式解读。记录结石的存在、数量和大小，并评估胆总管扩张情况。
23例患者中有15例被证实患有胆总管结石。结石大小范围为3毫米至35毫米（平均11毫米）。HASTE磁共振胆胰管造影术在15例患者中的14例（93%）显示有结石；超声检查在15例患者中的9例（60%）显示有结石。在内镜逆行胆胰管造影术、HASTE磁共振胆胰管造影术和超声检查中，有12例患者显示胆总管扩张。在HASTE磁共振胆胰管造影图上，我们测量了所有患者的胆管直径。平均直径为11毫米，与内镜逆行胆胰管造影图上测得的平均直径13.5毫米具有良好的相关性（r = 0.82）。
HASTE磁共振胆胰管造影术能够无创且快速地显示胆总管结石的存在，并使阅片者能够评估胆管扩张程度。对于有胆管结石临床证据的患者以及无法进行内镜逆行胆胰管造影术的患者，该序列应被视为内镜逆行胆胰管造影术的替代方法。
