口服枸橼酸铁铵溶液在MR水成像中的应用

Application of oral ferric ammonium citrate solution in MR water imaging

目的:探讨口服枸橼酸铁铵溶液(FAC)在水成像中的应用价值。方法:回顾性分析74例口服FAC及20例未口服FAC行水成像检查的病人图像,评价胃肠信号消除情况和胰胆管及泌尿系的显示情况,并对图像质量进行评价。结果:采用Ridit分析,口服FAC组Raidit值的均数为0.94,未口服FAC组Raidit值的均数为0.50,计算u统计量为8.8076,P<0.001。74例口服FAC后MRCP及MRU扫描,胃和十二指肠内的高信号被完全抑制,除2例因腹水影响诊断外,其余病例图像质量均优,能更清晰显示胰胆管及泌尿道的正常及异常情况,对病变的定位、定性诊断率明显提高。相反,20例未口服FAC行水成像检查的病人图像,由于受胃肠内液体的影响,严重影响诊断。结论:FAC可完全抑制胃及十二肠内液体信号,排除干扰,明显提高水成像的图像质量,对诊断胰胆系及泌尿系病变具有重要的临床应用价值。

Objective： To discuss the value of oral ferric ammonium citrate （FAC） in magnetic resonance cholangiopancreategraphy （MRCP） and magnetic resonance urography （MRU）. Methods： Images of MRCP or MRU of seventy-four patients with oral FAC and twenty patients without oral FAC were retrospectively reviewed, the images quality was evaluated according to the elimination of gastrointestinal fluid signal and the presentation of biliary-pancreatic structure or urinary tract.Resets： The mean Raidit score of group without oral FAC was 0.5, and that of another with oral FAC was 0.94 （ P 〈 0.001）. Gastrointestinal signals artifacts of all patients with oral FAC were successfully suppressed, their MRCP and MRU images quality was good except two patients whose images quality was affected by hydropefitonia. The use of FAC could clearly show biliaty-pancreatic or urinary tract normal and disorder conditions, and could significantly increase the lesion＇ s diagnosis rote of localization and definition. On the contrary, the image quality of twenty patients without oral FAC was poor and influence the diagnosis significantly because of influence of gastrointestinal fluid. Conclusion： The use of FAC can suppress water signal from the gastrointestinal tract and can significantly improve the images quality in MRCP and MRU, and have important clinical value in biliary-pancreatic system and urinary system diseases.