【摘要】：目的探討磁共振釓塞酸二鈉增強(qiáng)膽道成像評價(jià)膽道功能的可行性。方法納入53例肝硬化ChildPugh評分A級患者為A級組;31例評分B/C級患者為B/C級組;18名正常成人為對照組。記錄所有受試者磁共振釓塞酸二鈉動(dòng)態(tài)增強(qiáng)掃描時(shí),延遲5、10、15、20和25 min膽總管、膽囊和十二指腸顯影時(shí)間,并采用分割χ2檢驗(yàn)對各組兩兩進(jìn)行比較,P0.0167為有統(tǒng)計(jì)學(xué)顯著差異。測量延遲25 min膽總管信號強(qiáng)度并比較3組之間的差異。采用Games-Howell法進(jìn)行3組間的比較,P0.05為統(tǒng)計(jì)學(xué)顯著差異。結(jié)果延遲10 min,B/C級組膽總管顯示率明顯低于對照組(32%vs 100%,χ2=21.339,P=0.000)和A級組(32%vs 87%,χ2=26.177,P=0.000),延遲20 min,B/C級組低于A級組(87%vs 100%,P=0.016)。延遲10、15、20及25 min,B/C級組膽囊顯示率明顯低于對照組(6%vs 78%,χ2=26.345,P=0.000;52%vs 100%,χ2=12.552,P=0.000;48%vs 100%,χ2=13.795,P=0.000;48%vs 100%,χ2=13.795,P=0.000)和A級組(6%vs 45%,χ2=13.800,P=0.000;52%vs 81%,χ2=8.153,P=0.004;48%vs 91%,χ2=18.559,P=0.000;48%vs 91%,χ2=18.559,P=0.000)。十二指腸顯影在各時(shí)間點(diǎn)均無顯著差異(P0.05)。膽總管信號強(qiáng)度在正常人群與肝硬化Child-Pugh A級患者之間無顯著差異(P=0.243),而在正常人群、肝硬化Child-Pugh A級與B/C級患者之間均有顯著差異(P0.001)。結(jié)論肝硬化尤其是Child-Pugh B/C級患者的膽管、膽囊顯影較正常人群延遲,且信號強(qiáng)度降低,磁共振釓塞酸二鈉增強(qiáng)膽道成像不僅反映了肝臟功能,也可用來評價(jià)膽道功能。
[Abstract]:Objective to evaluate the feasibility of gadolinium disodium magnetic resonance enhanced cholangiography for evaluating biliary function. Methods 53 patients with liver cirrhosis with ChildPugh grade A were enrolled as group A, 31 patients with B / C grade as B / P C group and 18 normal adults as control group. The time of choledochus, cholecyst and duodenum in all subjects was delayed by 5 ~ 1015 ~ (20) and 25 min in dynamic contrast-enhanced scanning of gadolinium disodium, and compared with each other by 蠂 ~ (2) test. P0.0167 was a significant difference between the two groups (P _ (0.0167) and P _ (0.0167). The signal intensity of common bile duct at 25 min delay was measured and the differences among the three groups were compared. Games-Howell method was used to compare the three groups, P0.05 was statistically significant difference. Results the choledochus display rate of 10 min,B/C delayed group was significantly lower than that of the control group (32%vs 100, 蠂 2 + 21.339P0. 000) and the A grade group (32%vs 87, 蠂 2 26. 177 P0. 000), and the delay of 20 min,. Group B / C was lower than group A (87%vs 100). The gallbladder display rate in the group of delayed 10 ~ 15 ~ 15 ~ 20 and 25 min,B/C was significantly lower than that in the control group (6%vs 78, 蠂 ~ 2 = 26.345), P ~ (0.000) ~ (52) vs 100), 蠂 ~ 2 ~ 2 ~ (12.552) P ~ (0.000) ~ 0.000 ~ (48) vs 100 ~ (th), 蠂 ~ 2 ~ (2) ~ (13) 795 ~ (-1) P ~ (0.000) ~ (0.000); 48%vs 100, 蠂 ~ 2 ~ (13.795) ~ (0.000) and Group A (6%vs _ (45), 蠂 ~ (2 +) ~ (13.800) P ~ (0.000) ~ (0.000) ~ (0.000) vs 81a), 蠂 ~ (2) ~ (2) ~ (8.153) P ~ (0.004) ~ (48) vs 91 ~ (th), 蠂 ~ 2 ~ 2 ~ (18.559) P 0.000 ~ (0.000), 蠂 ~ (2 +) ~ (18.559) P ~ (0.000) ~ (0.000). There was no significant difference in duodenal development at all time points (P0.05). There was no significant difference in signal intensity of common bile duct between normal subjects and Child-Pugh A patients with cirrhosis (P0. 243), but there was significant difference between Child-Pugh A and B / C patients in normal subjects (P0. 001). Conclusion Cholecystokineography in patients with cirrhosis, especially in Child-Pugh B / C grade, is delayed and the signal intensity is decreased. Mr enhanced cholangiography not only reflects liver function, but also can be used to evaluate biliary function.
【作者單位】： 解放軍第八一醫(yī)院影像科;
【基金】：全軍醫(yī)藥衛(wèi)生科研基金資助項(xiàng)目(編號:11MA052)
【分類號】：R575.2;R445.2

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