探讨Gd-BOPTA增强CE-MRC显示胆管成像最佳延迟时间和应用价值

To Explore the Optimal Delay Time and Application Value of GD-BOPTA Enhanced CE-MRC for Bile Duct Imaging

目的探讨磁共振特异性对比剂钆贝葡胺(Gd-BOPTA)增强后不同延迟时间的胆管成像(CE-MRC)和胆胰管水成像(3D-MRCP)对肝胆管的显示能力。方法对安徽医科大学附属阜阳医院就诊的61例肝功能正常的患者,均进行3D-MRCP和CEMRC检查,应用对比剂Gd-BOPTA进行CE-MRC检查,采用VIBE轴位及冠状位T1WI序列于对比剂注入45min、90min进行扫描,行MIP三维重组胆道系统,分析不同延迟时间的肝胆期对胆管的显示能力,并与3D-MRCP进行对比。结果两种不同延迟时间的肝胆期成像和3D-MRCP对显示肝内三级以下胆管、肝总管、胆总管、胆囊效果的差异无统计学意义(P>0.05),两种不同延迟时间的肝胆期成像对胆囊管的显示优于3D-MRCP(χ^(2)45min=17.1、χ^(2)90min=9.385,P<0.05);3D-MRCP和延迟45min对肝内三级以上胆管显示效果差异无统计学意义(χ^(2)=0.558,P>0.05);3D-MRCP对肝内三级以上胆管显示效果优于延迟90min扫描(χ^(2)=4.723,P<0.05)。结论磁共振特异性对比剂Gd-BOPTA对胆管系统成像具有可行性,且肝胆期延迟45min对肝内三级以上胆管显示效果与3D-MRCP相当,并优于延迟90min。

Objective To investigate the cholangiography(CE-MRC)and cholangiography(3D-MRCP)with different delay time enhanced by GADolinium beglumine(Gd-BOPTA),a magnetic resonance specific contrast agent,in hepatobiliary duct display.Methods All 61 patients with normal liver function in our hospital were examined by 3D-MRCP and CE-MRC,contrast agent Gd-BOPTA was used for CE-MRC examination,and VIBE axial and coronal T1WI sequences were used for scanning 45min and 90min after contrast agent injection,and MIP three-dimensional recombinant biliary system was performed.The bile duct display ability of hepatobiliary phase with different delay time was analyzed and compared with 3D-MRCP.Results There was no significant difference in the effect of the two kinds of hepatobiliary phase imaging and 3D-MRCP in the display of bile duct,common hepatic duct,common bile duct and gallbladder below the tertiary level in the liver(P>0.05),and the two kinds of hepatobiliary phase imaging with different delay time was superior to 3D-MRCP in the display of gallbladder duct(χ^(2)45min=17.1、χ^(2)90min=9.385,P<0.05).There was no significant difference between 3D-MRCP and 45min delay in intrahepatic bile duct display at tertiary level(χ^(2)=0.558,P>0.05).The effect of 3D-MRCP on intrahepatic bile duct display was better than delayed 90min scan(χ^(2)=4.723,P<0.05).Conclusion Mr Specific contrast agent gd-bopta is feasible for the imaging of bile duct system,and the effect of 45min delay of hepatobiliary phase on intrahepatic bile duct of tertiary level or above is equivalent to that of 3D-MRCP,and better than that of 90min delay.