口服枸橼酸铁铵在胆囊管MRCP检查中的应用价值

Application of oral ferric ammonium citrate in MR cholangiopancreatography of cystic duct

目的:研究磁共振胰胆管成像显示胆囊管的最佳检查方法,并比较口服枸橼酸铁铵后胆囊管显示率的变化。分析胆囊管的显示在临床中的应用价值。方法:53例行常规MRCP检查者为正常对照组,69例检查前口服枸橼酸铁铵患者为实验组。另27例先常规行MRCP检查,再口服枸橼酸铁铵后做MRCP。在MRCP图像上,多角度、多方位观察胆囊管的显示情况,比较正常对照组与实验组胆囊管的显示率,比较口服枸橼酸铁铵前后胆囊管显示率的变化情况。结果:53例行常规MRCP检查的胆囊管显示率为71.7%(38/53),69例口服枸橼酸铁铵后胆囊管的显示率为87.0%(60/69)。27例口服枸橼酸铁铵后做自身前后对照的病例中,服药前显示率为70.4%(19/27),服药后显示率为88.9%(24/27)。在正常对照组与实验组间及口服枸橼酸铁铵前后做MRCP检查的病例中,服药后胆囊管的显示率明显提高,并具有显著统计学意义。结论:检查前口服枸橼酸铁铵在MRCP技术中的应用提高了正常胆囊管的显示,有利于胆囊切除术前常规了解胆囊管的正常解剖及变异,避免术中不必要的胆源性损伤及术后并发症的发生。

Objective：To study the best method which showed the cystic duct by MR cholangiopancreatography. To study the display of the cystic duct compared by oral administration of ferric ammonium citrate（FAC）. To analyze the clinical application of the anatomic variations of the cystic duct. Methods： 53 cases of conventional MRCP were setected as the normal control, 69 cases of oral examination with FAC as the trial group. In another 27 cases, the first acquisition was conventional MRCP, MRCP was repeated after oral FAC solution. On MRCP images, the display of the cystic duct was acquired by muhi-angle, multi-faceted observation. The display of the cystic duct was compared between the normal control and the trial group, between before and after oral FAC solution. Results： In the normal control of 53 patients, the frequency of visualization of the cystic duct was 71.7% （38/53） on conventional MRCP examination. In the trial group of 69 patients, the frequency of visualization of the cystic duct was 87.0% （60/69） after oral FAC solution. In the 27 patients who taken orally FAC solution by self-control study, the frequencies of the visualization of the cystic duct were, 70.4 % （19/27） and 88.9 % （24/27） respectively. Tile display of the cystic duct taken orally FAC was increased obviously compared between the normal control and the trial group, between before and after oral FAC solution. There were a statistically sighificant difference. Conclusion：The display of the cystic duct was increased obviously after oral FAC solution in MR cholangiopancreatography. Tiffs technique is very important to assess preoperatively the anatomic variants of the cystic duct to avoid unnecessary operative exploration and postoperative complications.