口服枸橼酸铁铵在磁共振尿路成像中应用价值.docVIP

口服枸橼酸铁铵在磁共振尿路成像中应用价值 　 作者：周东海，何宁，莫建杰，位春萍，李刚 【关键词】 口服 　　Application value of oral ferric ammonium citrate solution in MR urography 　　【Abstract】 AIM: To study the value of oral ferric ammonium citrate (FAC) solution as a negative gastrointestinal contrast agent in MR urography (MRU). METHODS: Eightyfive subjects were divided into 2 groups: nonFAC group (43 cases) who were given routine MRU, and FAC group (42 cases) who had MRU after oral administration of FAC solution containing 900 mg FAC. New MRU images were obtained from the original images by maximum intensity projection technique. RESULTS: In nonFAC group, 4 of the images obtained were classified as grade 1, 6 as grade 2, 27 as grade 3 and 6 as grade 4, while in FAC group, 19 of the images obtained were classified as grade 1, 14 as grade 2, 6 as grade 3 and 3 as grade 4. Significant difference (u=-4.669, Plt;0.0005) was found by nonparametric rank test of 2 independent samples. CONCLUSION: MRU images obtained after oral administration of FAC solution show the suppression of water signal from the gastrointestinal tract and more clear images of urinary tract. 　　【Keywords】 magnetic resonance image; ferric ammonium citrate; administration, oral; contrast media 　　【摘要】 目的： 研究枸橼酸铁铵作为胃肠道阴性对比剂对改善磁共振尿路成像（MRU）质量的价值. 方法： 受检者85例，其中43例直接进行MRU检查，42例则口服枸橼酸铁铵溶液（内含900 mg枸橼酸铁铵）后进行MRU检查，原始图像经工作站处理，采用最大信号强度投影（MIP）技术获得新图像. 结果： 未服用枸橼酸铁铵组MRU图像中1级4例；2级6例；3级27例；4级6例. 服用枸橼酸铁铵组中1级19例；2级14例；3级6例；4级3例. 采用非参数两独立样本等级资料的秩和检验，计算统计量u值为-4.669, Plt;0.0005(双尾概率),两组结果有统计学意义. 结论： 口服枸橼酸铁铵溶液可很好地抑制胃肠道内的液体信号，排除其干扰，使MRU能更清楚地显示尿路影像. 　　【关键词】 磁共振成像；尿路造影术；枸橼酸铁铵；投药，口服；造影剂 　　0引言 　　磁共振尿路成像（magnetic resonance urography, MRU）在评价尿路疾病时被广泛应用，它作为一种无创伤性、无需腹部加压和无需注射造影剂的检查方法以及可以多角度旋转图像的特点，具有明显的优越性，在诊断上能部分取代排泄性尿路造影（intravenous urography, IVU）和逆行性尿路造影以及CT检查［1-3］. 但在实际行MRU时，胃肠道内的液体往往也同时显影，尤其是小肠和大肠内的液体信号对尿路背景影响较大，可对肾盏、肾盂、输尿管和膀胱的观察造成干扰. 我们探讨枸橼酸铁铵作为胃肠道阴性对比剂在消除胃肠道液体信号以改善MRU图像质量中的应用价值. 　　1材料和方法 　　1.1材料 　　枸橼酸铁铵泡腾颗粒（试字号为2002HL0365,生产批号为020417，北陆药业股份有限公司），用量为1.5袋/次（每袋3 g，含600 mg枸橼酸铁