3D-SPACE 联合3D-TSERT序列扫描技术在MRCP诊断结石中的价值

The value of 3D-SPACE combined with 3D-TSERT sequence scanning technology in MRCP diagnosis of calculi

    摘要
  • 摘要:
    目的 评估可变翻转角的三维快速自旋回波（3D-SPACE）联合三维快速恢复快速自旋回波（3D-TSERT）序列扫描技术在磁共振胰胆管成像（MRCP）诊断结石中的价值。
    方法 选取2019年1月至9月于徐州市中心医院确诊为胰腺和胆道结石的168例患者的临床资料进行回顾性研究，其中男性93例、女性75例，年龄24~70（42.91±3.20）岁。所有患者均行胰腺和胆道3D-SPACE和3D-TSERT序列的MRCP，以外科手术结果为诊断标准，分析并计算3D-SPACE、3D-TSERT序列及其二者联合对胰腺和胆道结石及不同大小、不同部位胰腺和胆道结石的检出率。采用ROC曲线分析3D-SPACE、3D-TSERT序列及其二者联合在MRCP对胰腺和胆道结石诊断中的灵敏度、特异度和准确率。2组间检出率的比较采用χ2检验。
    结果 3D-SPACE联合3D-TSERT序列对胰腺和胆道结石的检出率（98.45%，191/194）高于3D-SPACE （81.44%，158/194）、3D-TSERT（78.87%，153/194）序列，且差异均有统计学意义（χ2=12.738、13.461，均P<0.01）。3D-SPACE联合3D-TSERT序列对最大径≤0.8 cm胰腺和胆道结石的检出率（97.14%，102/105）高于3D-SPACE （69.52%，73/105）、3D-TSERT（66.67%，70/105）序列，且差异均有统计学意义（χ2=10.684、11.374，均P<0.01）。3D-SPACE联合3D-TSERT序列对胆囊结石、肝内胆管结石、胆总管结石、胆总管下端壶腹部结石、胰管结石的检出率高于3D-SPACE、3D-TSERT 序列，且差异均有统计学意义（χ2=9.105~15.715，均P<0.01）。3D-SPACE联合3D-TSERT序列扫描技术对胰腺和胆道结石诊断的灵敏度、特异度和准确率分别为89.73%、90.64%和88.26%，高于3D-SPACE （78.46%、79.68%、79.38%）、3D-TSERT（77.53%、78.62%、76.19%）序列。
    结论 3D-SPACE联合3D-TSERT序列扫描技术在MRCP中对不同部位胰腺和胆道结石（尤其微小结石）的诊断中具有很高的临床应用价值。

     

    Abstract:
    Objective To evaluate the value of variable flip angle three dimensional sampling perfertion with application optimized contrasts using deifferent flip angle evolutions (3D-SPACE) combined with three dimensional turbo spin echo retore (3D-TSERT) sequence scanning technology in the diagnosis of calculi using magnetic resonance cholangiopancreatography (MRCP).
    Methods A retrospective study was conducted on the clinical data of 168 patients diagnosed with pancreatic and biliary calculi in the Central Hospital of Xuzhou from January to September 2019. The patients comprised 93 males and 75 females, aged 24–70(42.91±3.20) years, who underwent pancreatic and biliary tract 3D-SPACE-sequence and 3D-TSERT-sequence MRCP. The surgical result was used as the diagnostic standard. 3D-SPACE-sequence, 3D-TSERT-sequence, and their combination were used to determine and analyze different sizes of calculi in the pancreas and biliary tract. The three methods were compared in terms of their detection rates of pancreatic and biliary tract calculi. Receiver operating characteristic curve was used to analyze the sensitivity, specificity, and accuracy of 3D-SPACE, 3D-TSERT sequence, and their combination in the diagnosis of pancreatic and biliary tract calculi in MRCP. χ2 test was used to compare the detection rates between the two groups.
    Result The detection rate of 3D-SPACE combined with 3D-TSERT sequence for pancreatic and biliary calculi (98.45%, 191/194) was higher than those of 3D-SPACE-sequence (81.44%, 158/194) and 3D-TSERT-sequence (78.87%, 153/194), and the difference was statistically significant (χ2=12.738, 13.461; both P<0.01). The detection rate of 3D-SPACE combined with 3D-TSERT sequence for pancreas and biliary tract calculi with maximum diameter ≤0.8 cm (97.14%, 102/105) was higher than those of 3D-SPACE-sequence (69.52%, 73/105) and 3D-TSERT-sequence (66.67%, 70/105), and the difference was statistically significant (χ2=10.684, 11.374; both P<0.01). The detection rates of 3D-SPACE combined with 3D-TSERT sequence for gallbladder calculi, intrahepatic bile duct calculi, common bile duct calculi, lower common bile duct ampullary calculi, and pancreatic duct calculi were higher than those of 3D-SPACE-sequence and 3D-TSERT-sequence, and the differences were statistically significant (χ2=9.105–15.715, all P<0.01). The sensitivity, specificity, and accuracy of 3D-SPACE combined with 3D-TSERT sequence for the diagnosis of pancreatic and biliary calculi were 89.73%, 90.64%, and 88.26%, respectively, which were higher than those of 3D-SPACE-sequence (78.46%, 79.68%, and 79.38%) and 3D-TSERT-sequence (77.53%, 78.62%, and 76.19%).
    Conclusion 3D-SPACE combined with 3D-TSERT sequence scanning technology has high clinical application value in the diagnosis of calculi (especially small calculi) through the MRCP of different parts of the pancreas and biliary tract.

     

    • HTML全文
    • 参考文献(19)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回