Simeone A, Carriero A, Armillotta M, Marano R, De Maio G, Scarabino T, Cammisa M, Rotondo A, Bonomo L
Istituto di Scienze e Formazione dell'immagine, Università G. D'Annunzio, Chieti.
Radiol Med. 1997 May;93(5):561-6.
The authors report their experience in the optimization of the diagnostic accuracy of Magnetic Resonance Cholangiography (MRC) to detect choledochal stones; pre- and post-MIP post-processing images were compared. Thirty patients with dilated biliary ducts (mean age: 55.6 years) were examined with MRC; two of them had stones in the intrahepatic biliary ducts. The gold standard and the inclusion criterion was ERCP. MRC was carried out with a 1.5 T superconductive magnet (Signa) with T2-weighted FAST SE sequences (TR/TE; 10000/256, matrix: 256 x 128, slice thickness: 3 mm, TA: 6 min 28 s). Coronal MR images were blindly studied before and after MIP post-processing; Friedman's test was used for statistical analysis (p < .05). ERCP showed 92 cases of choledocholithiasis, with the stones ranging .2 to 3.4 cm; MRC before MIP post-processing had 97.1% diagnostic accuracy, 97.8% sensitivity and 95.8% specificity. These values are significantly different from those obtained after MIP (91.4%, 86.9% and 95.8% respectively). In our experience, pre- and post-MIP post-processing MRC can be considered a reliable and accurate noninvasive technique to detect choledochal stones.
作者报告了他们在优化磁共振胆管造影（MRC）诊断胆总管结石准确性方面的经验；对最大密度投影（MIP）处理前后的图像进行了比较。对30例胆管扩张患者（平均年龄：55.6岁）进行了MRC检查；其中2例肝内胆管有结石。金标准和纳入标准为内镜逆行胰胆管造影（ERCP）。MRC使用1.5T超导磁体（Signa），采用T2加权快速自旋回波序列（TR/TE；10000/256，矩阵：256×128，层厚：3mm，采集时间：6分28秒）。在MIP处理前后对冠状位MR图像进行盲法研究；采用弗里德曼检验进行统计分析（p<0.05）。ERCP显示92例胆总管结石，结石大小为0.2至3.4cm；MIP处理前的MRC诊断准确率为97.1%，敏感性为97.8%，特异性为95.8%。这些值与MIP处理后获得的值（分别为91.4%、86.9%和95.8%）有显著差异。根据我们的经验，MIP处理前后的MRC可被认为是一种可靠且准确的检测胆总管结石的非侵入性技术。
