小肠MRI造影检查在16例回盲部病变鉴别诊断中的应用临床分析

Clinical analysis of differential diagnosis for 16 cases of ileocecal lesions with intestinal MRI angiography

[背景]分析回盲部病变的小肠MRI造影检查表现.评价其在回盲部疾病鉴别诊断中的应用价值.[病例报告]回顾性分析16例胃肠道疾病的回盲部病变临床资料.并与小肠镜检查结果进行比较.行MRI造影检查前口服给予2.5%(质量分数)等渗甘露醇溶液,之后皮下注射给予山莨菪碱.扫描方法包括冠状面单次激发快速自旋回波序列(SSFSE)、冠状面T2WI脂肪抑制序列、冠状面T1WI脂肪抑制序列和横轴位弥散加权成像,后行带脂肪饱和技术的LAVA扫描序列增强扫描.观察小肠肠管形态、管腔扩张程度、管壁厚度、肠管周围脂肪间隙、小肠管壁的强化程度及肠系膜周围淋巴结肿大程度.结果见,16例患者均可接受等渗甘露醇溶液,均未发现并发症,其中包括Crohn病8例、炎性肠病(结核待排)5例、消化道出血2例、肠易激1例.[讨论]小肠MRI造影检查安全、无创、无电离辐射,可全方位多维显示肠道病变.

BACKGROND To analyze the presentation of intestinal MRI angiography for the ileocecal lesions and to evaluate its application value of differential diagnosis. CASE REPORTS The clinical data of 16 cases of ileocecal lesions were retrospectively analyzed, and were compared with the inspection results of small intestinal endoscopy. Before the examination by MRI angiography, the patients were administrated by 2. 5% isotonic mannitol solution per and by subcutaneous injection of 5 mg of anisodamine. The scanning methods included coronal single shot fast spin echo sequence（SSFSE） in coronal section, T2 WI fat suppression sequence in coronal section, T1 WI fat suppression sequence in coronal section, diffusion weighted imaging in axial section and finally LAVA scanning sequences with fat saturation technique enhanced scan. We had observed the bowel morphology the degree of luminal expansion, wall thickness, fat space of intestinal canal around, the enhancement degree of small bowel wall and the enlargement of mesenteric lymph nodes around. 16 patients could all accepted isotonic mannitol solution withnot complications. In these patients 8 cases were Crohn disease5 cases were inflammatory bowel disease（tuberculosiswith row）, 2 cases were digestive tract hemorrhage and 1 cases was irritable bowel. DISCUSSION Intestinal MR imaging is safe, non-invasive and non ionizing radiation and can completely display intestinal lesions.