MRI-FIESTA成像序列对胆道结石的诊断价值

The value of MRI-FIESTA in the diagnosis of biliary system calculus

目的:评价FIESTA成像序列对胆道系统结石的诊断价值。方法:30例CT诊断为肝内胆管结石患者,其中14例伴肝外胆管结石(肝总管6例,胆总管结石8例),均行磁共振胰胆管水成像MRCP检查,同时对感兴趣区分别行薄层FRFFSE-T2WI脂肪抑制序列及FIESTA脂肪抑制序列扫描检查,比较其对结石的诊断符合率。所有病例后均经手术或ER-CP证实。结果:30例胆内胆管结石,MRCP+FRFFSE组阳性19例,符合率63%;MRCP+FIESTA组阳性26例,符合率87%,两者肝内结石符合率差异有统计学意义(P<0.05);而肝外胆管结石,MRCP+FRFFSE组阳性15例,其中假阳性1例,MRCP+FIESTA组阳性14例,两者符合率均近100%,肝外结石符合率无明显差异性。结论:FIESTA序列对胆道结石尤其是肝内结石有极高的临床诊断价值。

Objective：To evaluate the clinical diagnosis value of FIESTA in biliary calculus.Methods：30 patients with calculus of intrahepatic duct were examined by MRCP,FRFFSE and FIESTA,14 of 30 patients accompany with calculus of extrahepatc duct.Statistical differences were analyzed.Results：30 cases of calculus of intrahepatic duct,the positive rate of MRCP＋FRFSE is 63%;the positive rate of MRCP＋FIESTA is 87%.There was a significant difference（χ2=4.36,P〈0.05）.Conclusion：MRCP＋FIESTA have a high value for location and diagnosis of biliary system calculus, especially for calculus of intrahepatic duct.