| 王钧波,季敏,杨皓玮,沈全力,龚英,乔中伟.口服钆双胺注射液在小儿磁共振胰胆管成像中的应用[J].中国医学影像技术,2020,36(3): |
| 口服钆双胺注射液在小儿磁共振胰胆管成像中的应用 |
| Application of oral administration gadolinium diamine injection in MRCP in children |
| 投稿时间：2019-03-13 修订日期：2020-03-22 |
| DOI： |
| 中文关键词: 磁共振，钆双胺，磁共振胰胆管成像 |
| 英文关键词:Magnetic resonance Gadolinium acid glucosamine MRCP image quality |
| 基金项目:无 |
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| 摘要点击次数: 1057 |
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| 中文摘要: |
| 目的：应用口服钆双胺注射液(欧乃影)Gd-DTPA稀释液作为小儿胃肠道阴性对比剂,以提高小儿磁共振胰胆管成像(MRCP)图像质量。方法：(1)体外实验：配制0.2%,0.3%,0.5%钆双胺注射液(欧乃影)Gd-DTPA稀释液和纯水同时进行“T2_spc”序列扫描,结果发现0.5%的钆双胺注射液(欧乃影)GD-DTPA稀释液“抑水效果”最佳,故选用0.5%钆双胺注射液(欧乃影)GD-DTPA稀释液用于临床实验。(2)临床实验：选取2016-2017年度本院244例5-15岁行MRCP的患儿,检查1小时前开始口服0.5%的钆双胺注射液(欧乃影)GD-DTPA稀释液400ml,45分钟内喝完,再等待15分钟后行MRCP检查,检查图像经2位高年资儿科影像医师进行评分,评分标准按照：肠道内T2高信号液体影多,影响诊断记为1分；肠道内T2高信号液体影多,略有影响但可诊断记为2分；肠道内T2高信号中等量液体影,不影响诊断记为3分；肠道内T2高信号少量液体影,不影响诊断记为4分；肠道内无液体影,不影响诊断记为5分。两位医师评分不一致时,讨论决定最后分值。(3)对照组：随机选取2016-2017年度38例5-15岁在我院因非肝胆原因行腹部MRI检查患儿,进行MRCP扫描,评分方法及判断标准同方法(2)。以大于等于3分不影响诊断为合格标准,计算图像质量合格率。结果：244例病例中,记5分者共76例,占31.15%；记4分者95例,占38.93%；记3分者66例,占27.05%；记2分者5例,占2.05%；记1分者2例,占0.82%。合格率为97.13%。对照组38例患儿记5分者共2例,占5.26%；记4分者3例,占7.89%；记3分者13例,占34.21%；记2分者14例,占36.84%；记1分者6例,占15.79%。合格率为47.37%。比较试验组和对照组的合格率,两者之间有显著差异。结论：口服适宜配制比例的钆双胺注射液(欧乃影)GD-DTPA稀释液可明显改善图像背影中肠道内液体T2高信号的影响有助于提高小儿胰胆囊管的显示率。 |
| 英文摘要: |
| Objective: To explore the effect of oral administration of Gd-DTPA as a negative contrast agent on improving MRCP image quality in children. Methods: (1) In vitro experiment. We simultaneously scanned by "T2_spc" sequence with the Gd-DTPA diluent of 0.2%, 0.3% and 0.5% gadolinium diamine injection and pure water. The results showed that 0.5% GD-DTPA had the best water-inhibiting effect. Therefore, 0.5% GD-DTPA diluent of gadolinium diamine injection was selected for clinical experiment. (2) The experimental group: 244 patients treated from 2016 to 2017 were selected as the research subjects and received MRCP scan. The patient"s age ranged from 5 to 15 years. One hour before the examination, the patients began to take 0.5% GD-DTPA dilution 400ml orally and finished it in 45 minutes. And then the patients received MRCP scan after another 15 minutes. Examination images were scored by two senior pediatric radiologists. According to the number of T2 high signal in intestinal tract and its influence on diagnosis, the image quality was divided into 5 grades from 1 to 5 point. The qualified rate of image quality was calculated according to the criterion that the diagnosis was not affected by more than or equal to 3 points. (3) The control group: Thirty-eight children aged 5-15 years who underwent abdominal MRI for non-hepatobiliary reasons in our hospital from 2016 to 2017 were randomly selected for MRCP scanning. Scoring method and judging standard are the same to (2). Results: The pass rate of MRCP image quality (97.13%) in the experimental group was significantly higher than that in the control group (47.37%), P<0.05. The difference of MRCP signal intensity of two groups was statistically significant. Conclusion: Oral administration of GD-DTPA diluent with appropriate proportion of gadolinium diamine injection can significantly improve the effect of high signal intensity of intestinal fluid T2 in image background and help to improve the display rate of pancreaticobiliary duct in children. |
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