MR Examinatorial Strategy And Diagnostic Imaging Of Microliths In The Inferior Bile Commen Duct And Duodenal Papilla

[Objective] To elevate the detection rate of microliths in the inferior bile commonduct and duodenal papilla by the means of MR examinatorial strategy and scanning schema aimed directly at different object ,and to provide image evidence to clinic.[method] Prospective studying 75 patients examed in MR room of the firstaffiliated hospital of Kunming medical college for the reason of obstruction of biliary tract.All cases were confirmed by operation or endoscopic sphincterotomy (ES). MR imaging equipment named GE 1.5T SIGNA,equipped with 8 channel phased-array surface coil pairs.All patients were examed by two ways: routine MR scanning and personality scanning schema..Routine MR scanning sequences including SSFSE,FSPGR-T₁WI and BH Thick slab MRCP, position of scanning adopted normal axial view and coronal view. Personality examinatorial strategy adopted lamellar scanning by muti-directions such as axial view,coronal view,oblique coronal view,oblique sagittal view and so on, some cases jointed application with sequence named FEESTA. The normal thick of MRCP thinned to 20-30mm. Hypotonic medicine was injected in muscle if the lesions were not discovered or unclear.MR dynamic enhancement was processed in the lesion suspected tumor or inflammation. Contrast analyzing the result of the two scanning schema described as above.[result] All picture's quality achieved diagnositic requirement; Biliary ducts of all75 patients had dilated in different degree ,the shape of biliary ducts dilation seemed as drying-tree-branches.Normal scanning detected the positive rate of microliths was 54.7%,but lamellar MR scanning showed the positive rate of microliths was 77.3%, there was statistical significance between the different methods of scanning,the value of x² was 8.586,and the value of P < 0.05; Normal thickness(40mm) MRCP detected the positive rate of microliths was 61.3%,thinning MRCP (20-30mm thickness) showed the positive rate of microliths was68%, there was no statistical significance between the different methods of scanning, the value of P > 0.05;There were 46 cases jointed application with sequence named FIESTA in all 75 cases,which detected the positive rate of microliths was 95. 7%, normal MR detected the positive rate of microliths was 81.3%, there was statistical significance between the different methods of scanning,the value of x² was 5.095,and the value of P < 0.05.Normal MR connection with MRCP detected the positive rate of microliths was 81.3%, personality-scanning schema(including lamellar,muti-directions,using hypotonic medicine and so on) detected the positive rate of microliths was 97.3%, there was statistical significance between the different methods of scanning,the value of x² was 6.822,and the value of P < 0.05.[conclution] 1 Lamellar MR scanning is superiorer than normal MR scanning at theaspect of microliths detected rate,and thinning the thickness has no significant influence on the quality of image;2 Jointed application with muti-sequences can improve the detected rate of microliths.3 The scanning schema of personality can elevate the rate of diagnostic accuracy of microliths in the inferior bile common duct and duodenal papilla in contrast to normal MR scanning method;...