CAJ | 학술논문

目的：分析探讨薄层冠扫 SSFSE 序列在婴幼儿 MR 胆道成像中的临床应用价值。方法：婴幼儿胆道系统疾病患者24例，包括胆道闭锁7例、胆道扩张症13例、胆系结石4例，均行全腹部薄层冠状面单次激发快速自旋回波（SS-FSE）序列扫描，8例经15～20min 延迟后行 MRI 增强扫描。观察患儿肝内外胆道及其各级分支的解剖全貌、走行分布及通畅情况。结果：所有患儿的 MR 图像在显示肝胆管解剖方面均可达到质量良好（可显示肝内胆管二级以上分支）。胆道闭锁患儿表现为胆囊形态小或不显影，正常肝外胆道结构消失或显示不完整；胆道扩张症患儿表现为位于胆道走行区的囊性包块，伴或不伴有肝内外胆道不同程度扩张；胆系结石患儿表现为胆道/胆囊内短 T2信号充盈缺损，或伴近端胆道扩张。结论：薄层冠扫 SSFSE 序列具有扫描速度快、呼吸伪影少、无电离辐射、胆道系统与周围背景结构的对比度高等优势，较常规腹部 MRI 扫描能更细致地观察胆道系统的解剖结构和各级分支的走行、管径，了解病变全貌以及是否合并其它脏器异常，可作为婴幼儿胆道疾病的常规影像学检查手段。
목적：분석탐토박층관소 SSFSE 서렬재영유인 MR 담도성상중적림상응용개치。방법：영유인담도계통질병환자24례，포괄담도폐쇄7례、담도확장증13례、담계결석4례，균행전복부박층관상면단차격발쾌속자선회파（SS-FSE）서렬소묘，8례경15～20min 연지후행 MRI 증강소묘。관찰환인간내외담도급기각급분지적해부전모、주행분포급통창정황。결과：소유환인적 MR 도상재현시간담관해부방면균가체도질량량호（가현시간내담관이급이상분지）。담도폐쇄환인표현위담낭형태소혹불현영，정상간외담도결구소실혹현시불완정；담도확장증환인표현위위우담도주행구적낭성포괴，반혹불반유간내외담도불동정도확장；담계결석환인표현위담도/담낭내단 T2신호충영결손，혹반근단담도확장。결론：박층관소 SSFSE 서렬구유소묘속도쾌、호흡위영소、무전리복사、담도계통여주위배경결구적대비도고등우세，교상규복부 MRI 소묘능경세치지관찰담도계통적해부결구화각급분지적주행、관경，료해병변전모이급시부합병기타장기이상，가작위영유인담도질병적상규영상학검사수단。
Objective:To study the value of MR imaging with thin slice SSFSE sequence in the clinical application of displaying infants′biliary system.Methods:24 infants and young children (10d~3.5y)with biliary tract disease had MR biliary imaging.There were biliary atresia (7 cases),bile duct dilatation (13 cases)and cholelithiasis (4 cases).All patients had abdominal thin slice coronary SSFSE sequence scanning;8 patients had contrast enhanced MRI with delay time of 15~20min.The anatomy,thoroughness of intra-/extra-hepatic bile duct and their branches were displayed and studied.Results:The MR images displayed biliary system well in all patients,the second grade intrahepatic bile ducts could be assessed.Pa-tients with biliary atresia showed small/absence of gallbladder,disappearance/non-integrity of normal extrahepatic bile duct structures.Cystic masses located at biliary system region,accompanied,with or without intra-/extra-hepatic bile duct dilata-tion could be seen in patients with bile duct dilatation.Short T2 signal filling defect within gall bladder/bile ducts,accompa-nied with proximal bile duct dilatation could be assessed in patients with cholelithias.Conclusion:Thin slice coronary SSFSE sequence has the advantages including fast scan speed,less breathing artifact,with no ionization radiation,showing strong tissue contrast between biliary system and background structures.More details could be showed when compared with the routine abdominal MRI scan.The anatomy,pathway,diameter of biliary system and the whole view of lesion;as well as any accompanied intra-abdominal abnormality could also be assessed.SSFSE sequence can used as routine approach in displaying infants′biliary disorders.