摘要
目的:探讨MR注气小肠灌肠及MR水成像对小肠疾病的诊断价值。方法:对临床怀疑小肠疾病的41例患者行小肠磁共振成像检查。其中16例小肠插管注气约1000 ml后行磁共振小肠灌肠(注气灌肠组),另25例行小肠磁共振水成像(水成像组),其中24例口服2.5%的等渗甘露醇1500 ml,1例严重肠梗阻直接利用肠腔的液体作为肠道对比剂,除该例肠梗阻外,其余病例扫描前均静脉注射山莨菪碱20 mg以抑制肠蠕动。扫描序列包括:①注气灌肠组,静脉注射钆喷替酸匍甲胺(Gd-DTPA)12 ml后行冠状面和横断面自旋回波(SE)序列及快速扰相梯度回波(FSPGR)序列增强扫描;②水成像组,应用冠状面单次激发快速自旋回波(SSFSE)和FSPGR序列平扫及冠状面和横断面FSPGR、SE序列增强扫描;每个序列均带脂肪饱和技术。比较两组图像质量,并将小肠MRI的诊断结果与手术、病理结果或临床诊断对照。结果:1例克罗恩病(Crohn病)被误诊为淋巴瘤,1例小肠毛细血管扩张症和1例易激综合症MRI未发现异常,其余各例的MRI诊断均与手术、病理结果及临床诊断一致。水成像组屏气扫描的图像无呼吸运动伪影和磁敏感伪影,质量优于SE序列和注气灌肠组的图像。结论:MR注气小肠灌肠及水成像对诊断小肠器质性病变,尤其是Crohn病、肿瘤和鉴别小肠梗阻的原因具有重要价值,两种检查方法中,MR水成像较注气小肠灌肠更优越。
Objective：To compare the diagnostic value of air-inflated MR enteroclysis and hydro-MRI in small bowel disease. Methods：41 patients with suspected small bowel disease received small bowel MRI. 16 of 41 patients underwent MR enteroclysis after 1000ml of air was inflated into small bowel through a naso-enteric tube （designated as group of air-inflated enteroclysis）. In the other 25 of the 41 patients,hydro-MRI was performed （designated as group of hydro-MRD. 24 patients in group of hydro-MRI ingested 1500ml of 2.5 % osmotic mannitol,while in only 1 patient the intra-intestinal fluid was used as contrast medium without ingesting mannitol fluid preparation because of severe intestinal obstruction. Before MRI,all patients received 20mg of intravenous anisodamine to reduce intestinal peristalsis except that patient with severe small bowel obstruction. The MRI sequences used included：①For group of air-inflated MR enteroclysis： fat-saturated Gd-DTPA enhanced coronal and axial T1-weighted spin-echo （SE） and fast spoiled gradient echo （FSPGR） sequences were used;②For group of hydro-MRI： fat-saturated unenhanced coronal T2-weighted single-shot FSE （SSFSE）, T1 weighted coronal FSPGR,enhanced coronal and axial FSPGR as well as SE sequences were performed. Comparative study of the image quality of the two groups and correlative assessment of MRI findings with surgical and pathological results as well as clinical features were performed. Results：In our study, 3 misdiagnosed cases were encountered. 1 of the 3 cases misdiagnosed Crohn＇s disease as ＂lymphoma＂, the other 2 cases of intestinal telangietasia and irritable intestinal syndrome respectively both as ＂no abnormalities were found＂. Except these 3 cases,the MR diagnoses of the remaining 38 cases were all correct. Because lack of breathing and magnetic susceptibility artifacts, the image quality of the images with breath-holding of hydro-MRI was superior to those with SE sequence and air-inflated MR enteroclysis. Conclusion：Small bowel MRI （air-inflated MR enteroclysis and hydro-MRI） played an important role in the diagnosis of organic intestinal diseases, especially for the diagnosis of Crohn＇s disease,differential diagnosis of intestinal tumors and searching the causes of intestinal obstruction. In comparison to air-inflated MR enteroclysis,hydro-MRI seemed to be more practical and superior.
出处
《放射学实践》
2006年第3期223-227,共5页
Radiologic Practice
关键词
肠疾病
磁共振成像
灌肠
Intestinal diseases
Magnetic resonance imaging
Enema
