LAVA序列结合磁共振胰胆管水成像对胆总管小结石的诊断价值

Diagnostic value of combining LAVA sequence with magnetic resonance cholangiopancreatography for small common bile duct stones

摘要:

目的 研究肝脏容积加速采集成像（LAVA）结合磁共振胰胆管成像（MRCP）对胆总管小结石的诊断价值。方法 选取广东省高州市人民医院2020年9月至2022年7月163例胆总管结石患者，其中84例胆总管小结石（直径≤５mm）。所有患者接受磁共振检查，包括T2加权成像、T1加权成像、短时间反转恢复序列（STIR）、弥散加权成像、MRCP、LAVA，磁共振检查后1个星期内行经内镜逆行胆胰管成像（ERCP）检查并取石或胆总管外科手术。选取84例胆总管小结石在MRCP和LAVA序列上的影像表现，分析MRCP和LAVA对小结石的检出阳性率。结果 84例胆总管小结石，66例LAVA序列胆总管小结石为高信号改变；62例MRCP胆总管小结石表现为充盈缺损；LAVA结合MRCP胆总管小结石阳性数82例。结论 LAVA结合MRCP有助于提高胆总管小结石的诊断敏感性，比LAVA序列或MRCP序列对胆总管小结石的检出阳性率更高。

Abstract:

Objective To study the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) combined with liver acquisition with volume acceleration (LAVA) for small common bile duct stones.Methods From September 2020 to July 2022, there were altogether 163 patients with choledocholithiasis, including 84 cases of small common bile duct stones (no more than 5 mm in diameter). MRI examinations were performed before operation, including T1WI, T2WI, STIR, DWI, MRCP and LAVA, and 1 to 5 days after MR examination, surgery or ERCP lithotomy were performed. The imaging of 84 cases with small common bile duct stones were chosen in MRCP and LAVA, and the positive rates of MRCP and LAVA in the detection of small stones in the common bile duct were analyzed.Results In 84 cases of small common bile duct stones, 66 cases showed high signal changes in LAVA sequence, 62 cases showed filling defect in MRCP. LAVA combined with MRCP detected 82 positive cases of small stones in the common bile duct.Conclusion LAVA combined with MRCP is helpful to improve the diagnostic sensitivity of small common bile duct stones. The positive detection rate for small common bile duct stones of LAVA combined with MRCP is higher than that of LAVA sequence or MRCP sequence.