CT和MRI诊断胆囊腺肌瘤病的比较研究

Comparison of CT and MRI for the diagnosis of adenomyomatosis of the gallbladder

目的比较CT和MRI诊断胆囊腺肌瘤病(GBA)的作用与限度。方法分析19例经组织学证实的GBA患者的CT和MRI资料,比较常规T1WI、T2WI、3mm薄层T2WI、MRCP、平扫CT、螺旋CT胆道造影(SCTC),以及CT和MRI动态增强扫描各时相图像显示罗-阿窦和胆囊病变的能力。观察结果与病理标本所见对照。结果19例GBA包括局限型11例,节段型5例,弥漫型3例。MRI显示罗-阿窦优于CT。胆汁显著浓缩时,SCTC可补充MRCP的不足。结论MRI诊断GBA的作用优于CT。

Objective To compare the role of CT and MRI in diagnosing adenomyomatosis of the gallbladder （GBA） based on imaging-pathologic correlation. Methods Pre-and post-contrast CT and MR imaging of 19 patients with GBA were studied. For each patient, 5 pulse sequences were performed in a 1.5T system, including axial 7 mm TlWI and T2WI, 3 mm thin-slice T2WI, MRCP and FSPGR triple-phase dynamic study; plain CT, dynamic CT and spiral CT cholangiography （SCTC） were also obtained for comparison. Two radiologists evaluated CT and MR images. Results Gallbladder wall thickening was visualized in all patients, the thickness was from 5 to 13 mm （mean 8 mm）. Among them, 11 fundal type, 5 segmental type, and 3 diffuse type of GBA were identified. Rokitansky-Aschoff sinuses （RAS） were seen in the thickened gallbladder wall and their sizes ranged from 3 to 7 mm （mean 4 mm）. MR imaging was superior to CT in showing RAS. SCTC was complementary to MRCP in showing RAS and contour of the gallbladder as highly concentrated bile existed. Conclusion MR imaging was superior to CT in diagnosing GBA.