Laghi A, Pavone P, Di Girolamo M, Catalano C, Panebianco V, Grossi A, Fanelli F, Assael F G, Passariello R
Istituto di Radiologia, Università degli Studi La Sapienza, Roma.
Radiol Med. 1996 Nov;92(5):600-4.
We investigated the role of new MR Imaging techniques for the diagnosis, characterization and staging of hepatic hydatid disease. We examined 21 patients (30 hydatid cysts), 7 men and 14 women, ranging in age 26 to 74 years, with known hydatid disease. MR examinations were carried out on a 0.5T superconductive magnet (Philips Gyroscan T5, Philips Medical System) with the following imaging protocol: T1w (TR/TE/NEX: 300/10/4) SE, T2w (TR/TE/NEX: 3000/120/6) TSE and fat suppressed (SPIR technique) T2w (TR/TE/NEX: 3000/120/6) sequences. MR Angiography examinations were performed with 2D Time of Flight sequences (TR = 33 ms; TE = 6.9 ms; flip angle = 60 degrees; slice thickness = 4.0 mm with 2.0 mm overlapping; matrix = 256 x 256; number of slices = 45-50; acquisition time = 4 min 19 s), while MR cholangiography was performed with 3D, fat suppressed (SPIR) Turbo Spin-echo (TSE) sequences (TR = 3000 ms, TE = 700 ms, ETL = 12, acq. time = 5 min 48 s). MRI correctly detected all the hydatid cysts on both T1- and T2-weighted images. Characterization was correct in all the cysts larger than 3 cm, where typical signs consistent with hydatid disease were detected. MRA images always showed the inferior vena cava and the splenoportal system. The portal vessels were demonstrated only up to the first branches. In 3 cases an extrinsic compression of the inferior vena cava was diagnosed. MRC, performed in 7 cases, showed normal main bile duct caliber in 6 cases, while in another case, where a cyst ruptured inside the bile ducts, the communication between the cyst and the bile ducts was clearly demonstrated. In conclusion, MR Imaging is a valuable tool in the study of liver hydatid disease. Moreover, the availability of such new MR techniques as MRC and MRA, greatly improves the diagnostic role of MR imaging, especially when studying complications and before surgery.
我们研究了新型磁共振成像（MR）技术在肝包虫病诊断、特征描述及分期中的作用。我们对21例（共30个包虫囊肿）已知患有包虫病的患者进行了检查，其中男性7例，女性14例，年龄在26至74岁之间。MR检查在一台0.5T超导磁体（飞利浦Gyroscan T5，飞利浦医疗系统）上进行，采用以下成像方案：T1加权（TR/TE/NEX：300/10/4）自旋回波（SE）序列、T2加权（TR/TE/NEX：3000/120/6）快速自旋回波（TSE）序列以及脂肪抑制（频谱预饱和反转恢复（SPIR）技术）T2加权（TR/TE/NEX：3000/120/6）序列。磁共振血管造影（MRA）检查采用二维时间飞跃（TOF）序列（TR = 33毫秒；TE = 6.9毫秒；翻转角 = 60度；层厚 = 4.0毫米，层间距2.0毫米；矩阵 = 256×256；层数 = 45 - 50；采集时间 = 4分19秒），而磁共振胰胆管造影（MRC）采用三维脂肪抑制（SPIR）快速自旋回波（TSE）序列（TR = 3000毫秒，TE = 700毫秒，回波链长度（ETL） = 12，采集时间 = 5分48秒）。MRI在T1加权和T2加权图像上均正确检测出了所有包虫囊肿。对于所有大于3厘米的囊肿，其特征描述均正确，在这些囊肿中检测到了与包虫病相符的典型征象。MRA图像总能显示下腔静脉和脾门静脉系统。门静脉仅显示至第一级分支。在3例中诊断出下腔静脉存在外在压迫。7例患者进行了MRC检查，6例显示主胆管管径正常，而在另一例囊肿破裂进入胆管的病例中，清晰显示了囊肿与胆管之间的连通。总之，MR成像在肝包虫病研究中是一种有价值的工具。此外，MRC和MRA等新型MR技术的应用，极大地提高了MR成像的诊断作用，尤其是在研究并发症及手术前。
