摘要
目的对比基于三维呼吸触发快速自旋回波(three dimensional respiratory-triggered turbo spin-echo,3D RT-TSE)序列与三维屏气梯度-自旋回波(three dimensional breath-hold gradient and spin-echo,3D BH-GRASE)序列的磁共振胰胆管成像(magnetic resonance cholangiopancreatography,MRCP)诊断肝外胆道系统结石的临床价值。材料与方法回顾性分析2017年11月至2022年11月苏州大学附属张家港医院74名因临床怀疑有胆结石而行MRCP检查的患者病例。所有患者均采用3D RT-TSE与3D BH-GRASE两种序列进行MRCP检查。由三名分别具有3年、6年及9年腹部MRI诊断经验的医师对所得图像进行整体图像质量评价,并对适合诊断的图像进行诊断评价。采用Wilcoxon符号秩检验,比较两种序列整体图像质量。采用McNemar检验,比较两种成像方法对肝外胆道系统结石的诊断结果。结果基于3D BH-GRASE序列的MRCP图像整体质量评分优于基于3D RT-TSE序列(Z=-7.286,P<0.001)。在诊断胆囊结石时,基于3D BH-GRASE序列的MRCP敏感度为92.3%,特异度为89.7%,准确度为91.2%;而基于3D RT-TSE序列的MRCP敏感度为66.7%,特异度为86.2%,准确度为75.0%;二者敏感度和准确度差异具有统计学意义(P≤0.002),特异度差异无统计学意义(P=0.317)。在诊断肝外胆管结石时,基于3D BH-GRASE序列的MRCP敏感度为72.7%,特异度为91.3%,准确度为85.3%;基于3D RT-TSE序列的MRCP敏感度为68.2%,特异度为91.3%,准确度为83.3%;二者差异均无统计学意义(P>0.05)。结论基于3D BH-GRASE序列的MRCP对肝外胆道系统结石的检测能力优于基于3D RT-TSE序列,合理应用MRCP检查序列可有效提高检查效率和诊断效能。
Objective:To compare clinical value of magnetic resonance cholangiopancreatography(MRCP)using three-dimensional respiratory-triggered turbo spin-echo(3D RT-TSE)sequence and three-dimensional breath-hold gradient and spin-echo(3D BH-GRASE)sequence in the diagnosis of extrahepatic cholelithiasis.Materials and Methods:A retrospective analysis was made on 74 patients who underwent MRCP due to clinical suspicion of cholelithiasis at the Affiliated Zhangjiagang Hospital of Soochow University from November 2017 to November 2022.Both 3D RT-TSE and 3D BH-GRASE sequences were employed for MRCP.Images of the two sequences were evaluated by three radiologists with 3,6 and 9 years of experience in abdominal MRI,respectively.Three radiologists independently evaluated the overall image quality of the acquired images and assessed the diagnostic quality of images suitable for diagnosis.The Wilcoxon signed-rank test was utilized to compare the overall image quality of the two sequences.The McNemar's test was employed to assess the differences in results obtained by the readers using the two imaging methods.Results:The overall quality scores of 3D BH-GRASE MRCP images were superior to those of 3D RT-TSE MRCP images(Z=-7.286,P<0.001).In the diagnosis of gallbladder stones,the sensitivity,specificity and accuracy of 3D BH-GRASE MRCP were 92.3%,89.7%and 91.2%,respectively,while for 3D RT-TSE MRCP,these values were 66.7%,86.2%and 75.0%,respectively.The difference of sensitivity,and accuracy between the two groups was statistically significant(P≤0.002),but the difference of specificity was statistically insignificant(P=0.317).In the diagnosis of extrahepatic bile duct stones,the sensitivity,specificity and accuracy of 3D BH-GRASE MRCP were 72.7%,91.3%and 85.3%respectively,whereas for 3D RT-TSE MRCP,these values were 68.2%,91.3%and 83.3%,respectively.There was no significant difference between them(P>0.05).Conclusions:3D BH-GRASE MRCP is superior to 3D RT-TSE MRCP in the detection of extrahepatic cholelithiasis.Reasonable optimization of MRCP sequence could enhance the efficiency of examination and diagnostic efficacy.
作者
许逸超
尹李俊
徐正道
黄秋亚
朱辰杰
陈建新
胡翼江
XU Yichao;YIN Lijun;XU Zhengdao;HUANG Qiuya;ZHU Chenjie;CHEN Jianxin;HU Yijiang(Department of Radiology,the Affiliated Zhangjiagang Hospital of Soochow University,Suzhou 215600,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2023年第11期62-67,83,共7页
Chinese Journal of Magnetic Resonance Imaging
基金
张家港市科学技术局社会发展技术创新研究项目(编号:ZKS2142)。
关键词
胆道结石
磁共振成像
磁共振胰胆管成像
诊断
cholelithiasis
magnetic resonance imaging
magnetic resonance cholangiopancreatography
diagnosis
