Comparative Study Of MRI Plain Scan,Contrast-enhanced MRI And 3D-MRCP In Evaluating The Imaging Diagnosis Of Duodenal Diverticulum

Objective: To investigate the clinical value of MRI in the diagnosis of duodenal diverticulum(DD)by analyzing the advantages and limitations of MRI plain scan,contrast-enhanced MRI and 3D-MRCP in the evaluation of DD.Methods: The imaging data of 51 patients with DD and non-DD patients who underwent MRI plain scan,contrast-enhanced MRI and 3D-MRCP confirmed by endoscopic retrograde cholangiopancreatography(ERCP)was retrospectively analyzed.The ROC curve analysis was performed to compare the effectiveness of the three MRI methods in the diagnosis of DD.The differences in imaging characteristics(location,size,shape,content,diverticulum neck,diverticulum wall)of 41 cases of DD assessed by the three MRI examination methods were compared.Results: 1.Through ROC curve analysis,we found that diagnostic power of contrast-enhanced MRI was best.The sensitivity,specificity,AUC and youden index of contrast-enhanced MRI in the diagnosis of DD were 0.976,0.900,0.938 and 0.875,respectively.2.The consistency of the three methods of MRI in measuring DD was excellent,the 95% confidence interval of ICC was(0.983,0.995).MRI plain scan and contrast-enhanced MRI showed no significant differences in DD morphology,content,and neck,kappa values were 0.773,0.013 and 0.231,respectively.The position and wall of DD on contrast-enhanced MRI were better than MRI plain scan.MRI plain scan and contrast-enhanced MRI showed the position,shape,content,neck and wall of DD were better than 3D-MRCP.Conclusion:1.MRI diagnosis of DD has good diagnostic accuracy and feasibility,provides a reliable image basis for clinical diagnosis and treatment,and has a good clinical application value.2.Advantages and limitations of different MRI examinations in evaluating the imaging characteristics of duodenal diverticulum.MRI plain scan has obvious advantages in evaluating the size,shape,content and neck of DD,but it is not well displayed for the position of DD and the condition of diverticulum wall.contrast-enhanced MRI has advantages in evaluating the position,size,shape,neck and wall of DD,but has poor ability for the content of DD.3D-MRCP is not valuable to evaluate DD alone,but it can be used as a specific sequence to observe the relationship between DD and cholangiopancreatic duct.3.The combined use of multiple sequences for MRI examination can realize multimodality,one-stop magnetic resonance diagnose of DD.