静脉注射钆喷酸葡胺增强改善MRCP图像质量研究

The image quality improvement of magnetic resonance cholangiopancreatography by intravenous Gd-DTPA enhancement

目的:评价静脉注射钆喷酸葡胺(Gd-DTPA)增强在改善磁共振胰胆管成像(MRCP)图像质量的作用。方法:选择临床疑有胰胆管病变并准备行MRI检查患者31例作为研究对象,所有患者分别行Gd-DTPA增强前及增强后1～5min、5～10min、10～15minMRCP扫描,测量并比较增强前后MRCP图像上肝脏、胰腺、胆总管、胰管的信噪比(SNR)以及胆总管与肝实质、胰管与胰腺的信号强度比(SIR)。结果:静脉注射Gd-DTPA增强后1～5min、5～10min及10～15min图像上胰胆管树各解剖结构显示情况和平均等级分数均无统计学差异(P>0.05);Gd-DTPA增强后的MRCP图像胰胆管树解剖结构显示情况和平均等级分数与增强前比较差异有显著性(P<0.001)。Gd-DTPA增强后MRCP图像上来自肠系膜上静脉及其分支与胰管重叠的血管信号、左右门静脉及其分支与肝内二级胆管重叠的血管信号被明显抑制,肝脏及胰腺信号强度降低,胰胆管树对比度提高,肝内2级胆管、肝总管、胆总管和胰管显示更加清楚。结论:MRCP成像中,静脉注射Gd-DTPA增强能抑制来自左右门静脉和肠系膜上静脉及其分支等血管的高信号,提高胰胆管树的对比度,明显改善MRCP图像质量。

Objective To evaluate the effect of intravenous gadopentetate dimeglumine （Gd-DTPA）enhancement on the image quality improvement of magnetic resonance cholangiopancreatography （MRCP）, Methods MRCP was performed in 31 patients with suspected biliary tract and pancreatic diseases before Gd-DTPA enhancement and 1 to 5 min, 5 to 10min, and 10 to 15 min after the enhancement. The signal-to-noise ratio （SNR） of the liver, pancreas, common bile duct, and pancreatic duct were measured, so were the signal intensity ratio （SIR） of the common bile duct relative to liver parenchyma and that of the pancreatic duct relative to stratify pancreatic parenchyma. Results The anatomic demonstrations and average grade scores of the pancreaticobiliary tree on MRCP differed significantly after Gd-DTPA enhancement （P 〈 0.001 ） but did not differ markedly at different time points after the enhancement （P 〉 0.05）. On Gd-DTPA MRCP images, the vascular signals from the superior mesenteric vein and its branches overlapping the pancreatic duct and from the right and left portal veins overlapping the second-order intrahepatic bile duct were markedly suppressed. The signal intensity of the liver and pancreas decreased while the contrast of the pancreaticobiliary tree increased. The images of the second-order intrahepatic bile duct, common hepatic duct, choledoch, and pancreatic duct of the pancreaticobiliary tree were clearer. Conclusions Gd-DTPA enhancement can suppress the signals from the right and left portal veins and from the superior mesenteric vein and its branches and improve the contrast of the pancreaticobiliary tree, resulting in notable improvement of MRCP image quality.