MR小肠造影前口服等渗甘露醇时间的探讨

发布时间：2018-06-10 06:02

本文选题：磁共振成像 + 小肠　；参考：《中国医学计算机成像杂志》2017年05期

【摘要】：目的:探讨选择口服等渗甘露醇在MR小肠造影效果的最佳时间。方法:对20例志愿者者行MR小肠造影,随机平均分两组:第一组检查前30min,第二组检查前45 min匀速口服2.5%等渗甘露醇2000ml做为肠道对比剂。MR扫描前1min肌注山莨菪碱20 mg抑制肠蠕动。扫描序列包括:(1)平扫:冠状面快速进动真稳态采集序列2D FIESTA,单次激发快速自旋回波(SSFSE)和快速扰相梯度回波(FSPGR);(2)增强:冠状面和横断面LAVA序列。记录患者小肠充盈效果,以差、优良等级评估,将MR小肠造影诊断结果与肠镜及临床诊断相对照。结果:20例(100%)回肠和空肠远段充盈效果优良。第一组呼吸运动伪影、肠蠕动伪影为1例,其余9例空肠近段充盈效果优良,图像可诊断率90%,诊断结果与病理或小肠镜相符7例,正确率77.8%(7/9);第二组4例空肠近段充盈良好,6例充盈效果差,其中呼吸运动伪影、肠蠕动伪影为1例,图像可诊断率40%,诊断结果与病理或小肠镜相符3例,正确率75%(3/4)。结论:在MR小肠造影前30min较检查前45min口服等渗甘露醇溶液小肠充盈效果更佳,口服等渗甘露醇法MR小肠造影是易行、可靠的小肠检查方法。
[Abstract]:Objective: to study the best time for selecting oral isosmotic mannitol in Mr enterography. Methods: 20 volunteers were randomly divided into two groups: the first group was given intramuscular injection of anisodamine 20 mg to inhibit intestinal peristalsis 30 minutes before examination, and the second group was given 2.5% isosmotic mannitol 2000ml at 45 min before examination. The scanning sequences include: 1) plain scan: 2D FIESTAA, single excitation fast spin echo (SSFSE) and fast scrambling phase gradient echo (FSPGRG) 2) enhancement: coronal plane and cross section LAVA sequences. The effect of small bowel filling was recorded, and the results of Mr enterography were compared with those of enteroscopy and clinical diagnosis. Results the filling effect of ileum and distal jejunum was good in 20 cases. In the first group, there were 1 case of intestinal peristalsis artifact and 9 cases of proximal jejunum filling. The diagnostic rate was 90%. The diagnostic results were consistent with pathology or enteroscopy in 7 cases. In the second group, 4 cases had good proximal jejunum filling and 6 cases had poor filling effect, including respiratory motion artifact, intestinal peristalsis artifact in 1 case, imaging diagnostic rate of 40%. The diagnostic results were consistent with pathology or enteroscopy in 3 cases, and the accuracy rate was 75 / 4%. Conclusion: the effect of 30min before Mr enterography is better than that of 45min before examination. The oral mannitol method is an easy and reliable method for small bowel examination.
【作者单位】：江南大学附属医院影像科;江南大学公共卫生研究中心;
【基金】：江南大学公共卫生研究中心立项项目No.1286010242150640~~
【分类号】：R445.2;R574

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