Rondeau Y, Soyer P, Meduri B, Spelle L, Gouhiri M, Aubert A, Scherrer A, Rymer R
Hôpital Foch, Suresnes.
J Radiol. 1998 Feb;79(2):147-52.
To evaluate a MR cholangiographic technique using a non breath-hold fast spin-echo technique in patients with suspected bile duct obstruction.
Twenty patients with suspected bile duct obstruction were prospectively investigated with MR cholangiography using a T2-weighted non breath-hold fast spin-echo technique (TR = 8000-9000 mse, effective TE = 120-266 msec, ETL = 16-32, acquisition time = 1-3 min) with a body coil. Results of MR cholangiography were compared to those obtained with endoscopic retrograde cholangiography (n = 20 patients) and endoscopic sonography (n = 12 patients) that were considered as reference.
MR cholangiography provided high-quality images in 19 out of 20 cases (95%). MR cholangiography had 100% sensitivity, 100% specificity and 100% accuracy in the diagnosis of bile duct dilation. MR cholangiography had 73% sensitivity, 75% specificity and 73% accuracy in the diagnosis of bile duct obstruction. MR cholangiography failed to depict small stones (< 3 mm) of the main bile duct in 4 cases in which no bile duct dilatation was found.
MR cholangiography using a non breath-hold fast spin-echo technique depicts bile duct dilatation with a degree of accuracy comparable to that achieved with endoscopic examination. In the absence of bile duct dilatation, small stones of the main bile duct may be undetected with MR cholangiography.
评估一种使用非屏气快速自旋回波技术的磁共振胆胰管造影术(MR cholangiography),用于疑似胆管梗阻患者。
对20例疑似胆管梗阻患者采用T2加权非屏气快速自旋回波技术(TR = 8000 - 9000毫秒,有效TE = 120 - 266毫秒,回波链长度ETL = 16 - 32,采集时间 = 1 - 3分钟),通过体线圈进行前瞻性磁共振胆胰管造影研究。将磁共振胆胰管造影的结果与被视为参考标准的内镜逆行胰胆管造影(20例患者)和内镜超声检查(12例患者)的结果进行比较。
20例中有19例(95%)磁共振胆胰管造影获得了高质量图像。磁共振胆胰管造影在胆管扩张诊断中的敏感性、特异性和准确性均为100%。在胆管梗阻诊断中,磁共振胆胰管造影的敏感性为73%,特异性为75%,准确性为73%。在4例未发现胆管扩张的病例中,磁共振胆胰管造影未能显示胆总管内小于3毫米的小结石。
使用非屏气快速自旋回波技术的磁共振胆胰管造影术在显示胆管扩张方面的准确性程度与内镜检查相当。在没有胆管扩张的情况下,磁共振胆胰管造影术可能无法检测到胆总管内的小结石。