3D-MRCP和MRU中使用枸橼酸铁铵的研究

Application of Ferric Ammonium Citrate in 3D-MRCP and MRU

目的:评价使用枸橼酸铁铵后3D-MRCP和MRU图像改善的情况。方法:46例患者(MRCP30例,MRU16例)在服用枸橼酸铁铵前、后以相同的采集参数分别行3D-MRCP或MRU成像。图像评价从胃肠信号消除情况和图像改善情况两方面进行。结果:使用对比剂后胃部的对比信噪比由7.064±3.853降至1.041±0.459,十二指肠信号由5.494±3.916降至1.931±2.317。统计学方法表明胃及十二指肠的对比信噪比在使用对比剂后降低差异均有显著性意义(P<0.001);左、右肾门周围的小肠信号则分别由1.1019±1.2223,1.2756±0.9630降至0.6175±0.3877和0.5662±0.3223,差异有显著性意义(P<0.05);而左、右两区间的小肠信号降低程度差异无显著性意义(P>0.05)。MRCP的图像质量由服药前的2.833±2.052增至9.133±2.030(P<0.001)。MRU的图像质量在服药前后则分别为4.2500±1.8439,7.7500±1.8439(P<0.05)。结论:枸橼酸铁铵的使用可有效消除3D-MRCP和MRU图像中的胃肠信号,明显改善图像质量。

Objective：To evaluate the elimination of the gastrointestinal signals in 3 dimentional magnetic resonance cholangiopancreatography （MRCP） and 3 dimentional magnetic resonance urography （MRU） after using ferric ammonium citrate （FAC）. Methods： 46 patients were involved （30 MRCP patients, 16 MRU patients） in this study. We performed 3D- MRCP or 3D-MRU imaging on these patients both before and after taking FAC,with the same parameters for either examination. Image assessment was based on the extent to which the gastrointestinal signals were eliminated （contrast effect） and to which the image quality was improved （image effect）. Wilcoxon test was used for statistical analysis. Results： After administration,the rS/N rate of the stomach was decreased to 1. 041±0. 459 from primary 7. 064±3. 853 （P〈0. 001） ,while the rS/N rate of the duodenum was 1. 931±2. 317 compared with 5. 494±3.91 before administration （P〈0. 001）. After administration,the signal intensity of the intestine around left renal hilum was decreased to 0. 6175±0. 3877 from primary 1. 1019±1. 2223 （P=0.02） ,while the signal intensity was 0. 5662±0. 3223 from primary 1. 2756±0. 9630 （P=0. 003） for the other side. The image quality of MRCP was significantly elevated to 9. 133 ± 2. 030 after administration from primary 2. 833±2. 052 （P〈0. 001）. The image quality of MRU was significantly elevated to 7. 7500±1.8439 after administration from primary 4. 2500±1. 8439 （P=0. 001 ）. Conclusion： FAC can effectively suppress gastrointestinal signals and improve image quality significantly in 3D-MRCP and 3D-MRU.