MRI-FIESTA成像序列对胆道结石的诊断价值

Diagnosis of bile duct stone using fat-suppressed FIESTA sequence

目的评价磁共振FIESTA序列对胆道系统结石的诊断价值。方法搜集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,同时对兴趣区分别行薄层FRFFSE-T_2WI脂肪抑制序列及FIESTA脂肪抑制序列扫描检查,比较两组对结石的诊断符合率。所有病例后均经手术或ERCP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 value of fat-suppressed FIESTA sequence for diagnosing biliary calculus. Methods 30 patients with intra-hepatic bile duct stones on CT underwent MRCP examination. 14 of 30 cases also had extra-hepatic bile duct stones. The area of interest was scanned using thin-slice FRFFSE and FIESTA sequences. The diagnostic accuracy with FRFFSE or FIESTA was compared. The diagnosis was confirmed by surgery or ERCP on all patients. Results The accuracy of FRFFSE and FIESTA was 63% and 87% respectively for detecting intra-hepatic bile duct stones. The difference was significant （x^2=4.36, P〈0.05）. There was no significant difference in detection of the 14 cases of extra-hepatic bile duct calculus. Conclusion FIESTA has great value in diagnosis of intra- hepatic bile duct stones.