磁共振钆塞酸二钠增强胆道成像评价肝硬化患者胆道功能

发布时间：2018-11-19 09:45

【摘要】：目的探讨磁共振钆塞酸二钠增强胆道成像评价胆道功能的可行性。方法纳入53例肝硬化ChildPugh评分A级患者为A级组;31例评分B/C级患者为B/C级组;18名正常成人为对照组。记录所有受试者磁共振钆塞酸二钠动态增强扫描时,延迟5、10、15、20和25 min胆总管、胆囊和十二指肠显影时间,并采用分割χ2检验对各组两两进行比较,P0.0167为有统计学显著差异。测量延迟25 min胆总管信号强度并比较3组之间的差异。采用Games-Howell法进行3组间的比较,P0.05为统计学显著差异。结果延迟10 min,B/C级组胆总管显示率明显低于对照组(32%vs 100%,χ2=21.339,P=0.000)和A级组(32%vs 87%,χ2=26.177,P=0.000),延迟20 min,B/C级组低于A级组(87%vs 100%,P=0.016)。延迟10、15、20及25 min,B/C级组胆囊显示率明显低于对照组(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级组(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)。十二指肠显影在各时间点均无显著差异(P0.05)。胆总管信号强度在正常人群与肝硬化Child-Pugh A级患者之间无显著差异(P=0.243),而在正常人群、肝硬化Child-Pugh A级与B/C级患者之间均有显著差异(P0.001)。结论肝硬化尤其是Child-Pugh B/C级患者的胆管、胆囊显影较正常人群延迟,且信号强度降低,磁共振钆塞酸二钠增强胆道成像不仅反映了肝脏功能,也可用来评价胆道功能。
[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.
【作者单位】：解放军第八一医院影像科;
【基金】：全军医药卫生科研基金资助项目(编号:11MA052)
【分类号】：R575.2;R445.2

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