肝移植术后磁共振成像技术研究

Orthotopic Liver Transplantation: Evaluation with MRI

目的 探讨磁共振 (MR) 技术在肝移植术后的应用价值。方法 用快速自旋回波序列 (TSE) 及小角度激发快速梯度回波序列 (FLASH) 常规扫描、磁共振弥散成像 (DWI)、磁共振胆管成像 (MRCP)、钆喷替酸葡甲胺(Gd- DTPA) 动态增强三维磁共振血管成像 (3D- CE- MRA) 检查13例肝移植术后患者, 共行MR检查21次。分析各序列图像质量。结果 常规MR平扫可观察移植肝的形态特征。小角度激发快速梯度回波 T1 加权成像 (FLASH -T1WI) 增强序列可反映移植体的强化程度, 间接反映移植肝的活性。DWI 可发现小的肝癌复发病灶。MRCP可直观反映胆道系统及胰管情况, 增强后MRCP图像质量较未增强 MRCP好。增强血管成像 (CE- MRA) 可较好地显示血管及移植体血运情况, 但需结合轴位图像对比分析以正确判断血管并发症。结论 正确完善的MR扫描方法可客观反映移植肝的形态及功能, 可准确、快速诊断肝移植术后出现的并发症, 对指导临床诊断及治疗有重要意义。

Objective To explore the applied value of MR technique in orthotopic liver transplantation. Methods Thirteen consecutive adult patients underwent 21 imaging examinations after orthotopic liver transplantation using a breath-hold 2 dimension turbo spin echo (TSE) and fast low angle shot (FLASH), diffusion-weighted imaging (DWI), MR cholangiopancreatography (MRCP) and triphasic contrast-enhanced 3D imaging of Gd-DTPA were performed.The imaging characteristics of each sequence were analyzed. Results Morphologic description of the grafts could be detected by routine sequences.The graft enhancement was displayed on FLASH-T 1WI following gadolinium injection.DWI could discover the small recrudescent hepatocarcinoma.MRCP descripted the condition of biliary system and pancreatic duct.Enhanced MRCP had better quality than non-enhanced one.MRA was a technique for detecting the vasculature and evaluating the flow to grafts. Conclusion The precise consummate scan method can reflect morphology and function of grafts objectively.MRI is an effective way to detect the recipient.