用MRI无损检测胆囊中的胆汁成

为了探索用磁共振成象方法无损伤检测胆囊中的胆汁成分的可能性,我们用0.5T的磁共振成象仪,对38例禁食期胆囊疾病患者(12例急性无并发症胆囊炎及胆结石,1例化浓性胆囊炎,2例急性出血性胆囊炎,14例慢性胆囊炎及胆结石,5例胆囊息肉,4例障碍性黄疸进行了轴向腹部胆囊部位T1-加权自旋-回波成象.结果表明:禁食或胆囊疾病患者胆汁中胆固醇(p=0.014),脂肪酸(p=0.001),和铁(p<0.001)的浓度对T₁-加权成象(TR/TE=620/25ms)的肝-胆信号强度比有明显的负影响,同时发现总蛋白质,总胆红素及Na⁺,K⁺,Cl^-,Mg⁺⁺离子的浓度对肝-胆MRI信号强度比无显著影响,由此可见,T₁-加权MRI中的肝-胆信号强度比反映了胆囊中的胆汁成分,其中影响肝-胆信号强度比的最重要因素是胆囊中胆汁所含胆固醇、脂肪酸和铁的浓度.

NONINVASIVE EVALUATION OF GALLBLADDER BILE COMPOSITION BY MRI

In order to explore the possibility of MRI in the noninvasive evaluation of gallbladder bile composition T1 - weighted spin - echo exial abdominal MR image at 0.5T and gallbladder bile compositon were obtained in 38 individuals (12 with acute uncompli-cated cholecystitis and gallbladder gallstones, 1 patient with suppurative cholecystitis, 2 with acute hemorrhagic cholecystitis, 14 with chronic cholecystitis and gallbladder stones, 5 with gallbladder polyps, 4 with obstructive jaundice) in fast stage. The results show that the concentrations of cholesterol (p = 0.014), fatty acids (p = 0.001) and iron (1, < 0.001) in the gallbladder bile in fast stage were significantly and negatively associated with liver- gallblad-der signal intensity ratio on the T1 weighted image (TR/TE = 620/25 ms). No significant association was found betweell the liver - gallbladder signal intensity ratio and the concen-trations of total protein, total bilirubin, Na+, K+, Cl- and Mg++. We conclude that the liver- gallbladder signal intensity ratio on the T1- weighted RM image can reflect gallbladder bile composition. The strongest determinants of the liver - gallbladder signal intensity ratio are the concentrations of cholesterol, fatty acids and iron.