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Periampullary Obstructive Disease: Bowel Preparation and LAVA Dynamic Enhanced MR Scan

Author: ChenQingSheng
Tutor: DuYong
School: North Sichuan Medical College
Course: Medical Imaging and Nuclear Medicine
Keywords: Periampullary obstruction LAVA dynamic contrast-enhanced Bowel preparation The gadolinium Tony meglumine Delayed scan
CLC: R445.2
Type: Master's thesis
Year: 2011
Downloads: 14
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Abstract


Objective: To discuss the hypotonic oral contrast agents and hypotonic oral contrast agents three scan bowel preparation combined the LAVA sequence of scans of normal duodenal periampullary anatomical structures show differences. Materials and Methods: 36 cases of healthy volunteers were randomly divided into three groups, respectively, using the IM 654-2, drinking and intramuscular 654-2 drinking the bowel preparation before scanning. 3 group of volunteers underwent bowel preparation before SPGR T1WI sequence LAVA sequence scanning bowel preparation the LAVA sequence of scanning. The scanned images independent blinded analysis by two abdominal imaging experts. In each experimental group bowel preparation prior to analysis, after the image and the different methods of experimental group after bowel preparation periampullary anatomical structures between the image display differences. Image in accordance with the display of the common bile duct, ampulla and duodenal papilla and duodenal intestine diameter, three aspects of evaluation of the duodenal mucosa morphology were divided into four grades. Wilcoxon test was used for statistical analysis, the statistical results take P lt; 0.05 was considered statistically significant. Results: simple intramuscular 654-2 group, group and intramuscular injection of pure drinking water the 654-2 drinking group three groups (1 and 2) expansion of duodenal intestine Example axial observation (Coronal observation) : axis 9 cases (crown), axis 3 cases (crown three cases), the axis 10 cases (crown 10 cases), P lt; 0.05; common bile duct, ampulla and duodenal papilla The number of cases: the axis 10 cases (crown), axis 3 cases (crown three cases), the axis 10 cases of (crown 10 cases), P lt; 0.05; duodenal mucosal morphology shows a good countdown respectively : Axis 3 cases (crown 3 cases), shaft 10 patients (the crown nine cases), the axis of 9 cases of 10 cases (crown), P lt; 0.05. Conclusion: intramuscular 654-2 drinking water after bowel preparation LAVA scanned image display capabilities of the anatomical structure of the normal duodenal periampullary better than simple intramuscular 654-2 or pure drinking water bowel preparation. Experiment II clinical cases observed Objective: To analyze the common lesions in patients with ampullary obstruction bowel preparation (hypotonic drinking water) the intravenous gadolinium Tony meglumine LAVA dynamic contrast-enhanced MR characteristics and diagnostic value of scanning with conventional MRI scan. Materials and Methods: 43 cases of ampullary obstruction were included in the study, subjects with conventional MRI scan after intramuscular 654-2 drinking bowel preparation, the intravenous gadolinium Tony meglumine underwent LAVA dynamic contrast-enhanced scan, the last intravenous contrast delayed scan line LAVA sequence of 6-8 minutes and 90 minutes after the agent. The scanned images independent blinded analysis by two abdominal imaging experts, analysis ampullary obstruction common lesions by MR imaging display rate, while the common lesion diagnostic value of MRI diagnosis ampullary obstruction evaluation of this study. Results: common bile duct stones visible The dynamic scanning period no strengthening nodules (94.1% for bile duct cavity, 16/17) and obstruction of the upper end of bile duct dilatation (100%, 17/17). The periampullary tumors performance visible gall irregular wall thickening the ampulla surrounding soft tissue nodules, lumps strengthen (89.5%, 17/19), and bile duct dilatation (100%, 19/19). After bowel preparation the intravenous gadolinium Tony meglumine LAVA dynamic contrast-enhanced scanning with conventional MRI scan sensitivity for the diagnosis of common bile duct stones, specificity and accuracy were 94.1%, 100%, 97.7%; around the diagnosis of ampulla tumor sensitivity, specificity, and accuracy of 94.7%, 95.8%, 95.3%. Conclusion: intramuscular 654-2 after drinking LAVA dynamic contrast-enhanced scanning with conventional MRI scan the signs display rate can increase periampullary obstructive lesions, improve the diagnostic value of MRI.

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CLC: > Medicine, health > Clinical > Diagnostics > Diagnostic Imaging > Magnetic resonance imaging
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