MRI技術(shù)進(jìn)展及臨床應(yīng)用課件

1、MRI技術(shù)進(jìn)展及臨床應(yīng)用第二軍醫(yī)大學(xué)長(zhǎng)海醫(yī)院放射科陸建平MRI技術(shù)進(jìn)展及臨床應(yīng)用1MRI技術(shù)進(jìn)展及臨床應(yīng)用第二軍醫(yī)大學(xué)MRI技術(shù)進(jìn)展及臨床應(yīng)用MRI技術(shù)進(jìn)展特點(diǎn)硬件和軟件齊頭并進(jìn)，軟件進(jìn)步更快，更注重臨床實(shí)際應(yīng)用。設(shè)備發(fā)展的兩極化明顯，高檔設(shè)備用于臨床研究與功能的開(kāi)發(fā)，低檔設(shè)備移植高、中檔設(shè)備已開(kāi)發(fā)較成熟的功能和軟件，改善性能指標(biāo)，拓寬適用范圍。成像速度越來(lái)越快，實(shí)時(shí)成像逐步應(yīng)用于臨床。解剖成像與功能成像相結(jié)合。影像診斷與介入治療設(shè)備相結(jié)合。MRI技術(shù)進(jìn)展及臨床應(yīng)用2MRI技術(shù)進(jìn)展特點(diǎn)硬件和軟件齊頭并進(jìn)，軟件進(jìn)步更快，更注重臨MR設(shè)備硬件的發(fā)展MR設(shè)備硬件的發(fā)展開(kāi)放型磁體設(shè)計(jì)和中場(chǎng)超導(dǎo)開(kāi)放式M

2、R設(shè)備初衷是強(qiáng)調(diào)作介入治療及檢查中的監(jiān)護(hù)等性能，實(shí)際用于介入治療的機(jī)會(huì)遠(yuǎn)少于常規(guī)診斷性操作。性能逐年提高，圖像質(zhì)量、可實(shí)施的功能、成像速度等性能已可達(dá)到較高水平，甚至不排除高場(chǎng)設(shè)備將來(lái)向開(kāi)放型設(shè)計(jì)轉(zhuǎn)化的可能性。較高的場(chǎng)強(qiáng)、改水平磁場(chǎng)為垂直磁場(chǎng)設(shè)計(jì)。梯度場(chǎng)強(qiáng)(可達(dá)15mT/m到20mT/m)和切換率進(jìn)一步提高，場(chǎng)均勻性更好，體積和重量更小。MRI技術(shù)進(jìn)展及臨床應(yīng)用3MR設(shè)備硬件的發(fā)展MR設(shè)備硬件的發(fā)展MRI技術(shù)進(jìn)展及臨床應(yīng)用MR設(shè)備硬件的發(fā)展專(zhuān)用MR設(shè)備目前MR專(zhuān)用機(jī)已作為成熟的機(jī)型推廣，部分醫(yī)院采用搭配添置通用MR機(jī)和專(zhuān)用MR機(jī)。MR專(zhuān)用機(jī)主要有頭顱專(zhuān)用機(jī)、心臟專(zhuān)用機(jī)與骨與關(guān)節(jié)專(zhuān)用機(jī)，頭顱與心

3、臟專(zhuān)用機(jī)為高場(chǎng)(或超高場(chǎng))機(jī)，如3.0T甚至4.7T設(shè)備；骨與關(guān)節(jié)專(zhuān)用機(jī)傾向?yàn)橹?、低?chǎng)開(kāi)放型設(shè)備。研究應(yīng)用及臨床應(yīng)用MRI技術(shù)進(jìn)展及臨床應(yīng)用4MR設(shè)備硬件的發(fā)展專(zhuān)用MR設(shè)備MRI技術(shù)進(jìn)展及臨床應(yīng)用4MR設(shè)備硬件的發(fā)展梯度場(chǎng)強(qiáng)改進(jìn)梯度場(chǎng)強(qiáng)決定切換率及最短TR、TE、圖像矩陣大小、成像速度、最小回波間隔等性能參數(shù)。但較高的梯度場(chǎng)會(huì)伴有磁體內(nèi)很強(qiáng)的梯度噪音及神經(jīng)肌肉刺激。增加梯度場(chǎng)強(qiáng)：可增加到30-40-50mT/m，同時(shí)伴有以下不同的技術(shù)措施。MRI技術(shù)進(jìn)展及臨床應(yīng)用5MR設(shè)備硬件的發(fā)展梯度場(chǎng)強(qiáng)改進(jìn)MRI技術(shù)進(jìn)展及臨床應(yīng)用5MR設(shè)備硬件的發(fā)展梯度場(chǎng)強(qiáng)改進(jìn)雙梯度系統(tǒng)：在磁體線圈內(nèi)，內(nèi)置較短的梯度線圈

4、，局部迭加較高梯度場(chǎng)，切換率可達(dá)150，用于功能性檢查。組合表面線圈系統(tǒng)：在頭線圈上附有一組梯度線圈，工作時(shí)形成了與雙梯度系統(tǒng)類(lèi)似的迭加梯度場(chǎng)，場(chǎng)強(qiáng)可達(dá)60mT/m，切換率可達(dá)400，適用于在高場(chǎng)條件下實(shí)施功能成像。多通道+多方向采集和多通道快速成像系統(tǒng)：是提高有效切換率的一種方式，可使30mT/m的梯度場(chǎng)強(qiáng)相當(dāng)于60mT/m者，切換率也可達(dá)400，使用時(shí)無(wú)神經(jīng)肌肉刺激。MRI技術(shù)進(jìn)展及臨床應(yīng)用6MR設(shè)備硬件的發(fā)展梯度場(chǎng)強(qiáng)改進(jìn)MRI技術(shù)進(jìn)展及臨床應(yīng)用6MR設(shè)備硬件的發(fā)展磁體降噪設(shè)計(jì)：體線圈內(nèi)置真空層及幾種技術(shù)的綜合。據(jù)介紹可使噪音水平下降90%。線圈的發(fā)展：各部分線圈相控陣化，提高信噪比；聯(lián)合

5、相控陣線圈用于全身各部位聯(lián)合檢查；新型線圈不斷開(kāi)發(fā)（如對(duì)稱(chēng)性體線圈）。MR磁體進(jìn)一步緊湊化：液氦消耗大幅度降低，運(yùn)行成本下降。重建速度進(jìn)一步增加：最快可達(dá)120幀/s，實(shí)時(shí)成像成為可能。MRI技術(shù)進(jìn)展及臨床應(yīng)用7MR設(shè)備硬件的發(fā)展磁體降噪設(shè)計(jì)：體線圈內(nèi)置真空層及幾種技術(shù)的MR設(shè)備軟件功能的發(fā)展功能性MRI(fMRI)已經(jīng)發(fā)展了數(shù)年的fMRI從廣義上主要包括灌注成像、彌散成像和腦皮質(zhì)功能定位。灌注與彌散成像較早應(yīng)用于顱腦，近年試用于心臟。近年內(nèi)fMRI的發(fā)展明顯拓寬了原有的概念與應(yīng)用范疇。MRI技術(shù)進(jìn)展及臨床應(yīng)用8MR設(shè)備軟件功能的發(fā)展功能性MRI(fMRI)MRI技術(shù)進(jìn)展功能性MRI(fMRI

6、) 神經(jīng)學(xué)功能性MRI顯微水、微血管動(dòng)力學(xué)、血氧/流消耗成像等實(shí)時(shí)fMRI，快速實(shí)時(shí)顯示。螺旋fMRI，利用在K-空間螺旋采集的技術(shù)得到各種腦血流灌注的信息，如rCBU、rCBF、rMTT等。彌散成像，進(jìn)一步提高設(shè)備可達(dá)到的B值，4000-10000，從而獲得更高分辨力的彌散影像彌散與灌注成像誤匹配成像，利用計(jì)算機(jī)技術(shù)把兩種影像迭加，通過(guò)對(duì)比可提高病變顯示率MRI技術(shù)進(jìn)展及臨床應(yīng)用9功能性MRI(fMRI) 神經(jīng)學(xué)功能性MRI顯微水、微血功能性MRI(fMRI) 神經(jīng)學(xué)功能性MRI動(dòng)脈血質(zhì)子自旋標(biāo)記成像?？寡苌梢蜃虞o助fMRI。張力性成像(tensor imaging),通過(guò)采集六個(gè)不同方

7、向的相位編碼，測(cè)定組織張力差別的成像方法.其它fMRI的新技術(shù)，如快速T1FLAIR(+對(duì)比劑注射)、FR FSE、相位敏感IR、快速SET2、自旋-彌散成像等。MRI技術(shù)進(jìn)展及臨床應(yīng)用10功能性MRI(fMRI) 神經(jīng)學(xué)功能性MRIMRI技術(shù)進(jìn)展及DW-EPI診斷急性腦梗塞FLAIRDiffusion-weighted EPI demonstrates acute stroke in parietal lobeSub-acute, chronic lesions appear isointense or hypointense relative to acute lesionFLAIR +

8、DW-EPI used to differentiate new from old lesionsDW-EPI陳舊區(qū)細(xì)胞毒性水腫區(qū)MRI技術(shù)進(jìn)展及臨床應(yīng)用11DW-EPI診斷急性腦梗塞FLAIRDiffusion-weNegative Enhancement Integral (NEI)rCBV灌注成象研究MRI技術(shù)進(jìn)展及臨床應(yīng)用12Negative Enhancement Integral Mean Time to Enhance (MTE, MTT)新浪潮軟件灌注成象研究MRI技術(shù)進(jìn)展及臨床應(yīng)用13Mean Time to Enhance (MTE, MTT Patient Status:

9、 post surgery and radiotherapy for glioblastoma EPI imaging is added to conventional MR to generate CBV Maps CBV Map can differentiate recurrent tumor from necrotic tissue or edemaEdema orRecurrent Tumor?Recurrent tumornot seen on T2 or T1Recurrent TumorCBV MapT2T1新浪潮軟件腦血流灌注診斷術(shù)后腫瘤再發(fā)MRI技術(shù)進(jìn)展及臨床應(yīng)用14 Pa

10、tient Status: post surgerySt. Lukes Hospital, Milwaukee, WI, Breger et al.FLAIR vs. Diffusionreveals acute infarctDiffusion vs. DSCreveals tissue-at-risk彌散成像和灌注成像診斷急性腦梗塞NEI圖MTE圖MRI技術(shù)進(jìn)展及臨床應(yīng)用15St. Lukes Hospital, Milwaukee, human brain mappingfMRI臨床應(yīng)用:功能區(qū)域定位刺激反應(yīng)程度手術(shù)計(jì)劃系統(tǒng)非損傷性治療MRI技術(shù)進(jìn)展及臨床應(yīng)用16 human brain

11、 mappingfMRI臨床應(yīng)用:AVM Patient presenting with AVM in middle temporal lobe fMRI of auditory activation performed with EPI imaging Eloquent region involved with auditory reception indentified posterior and superior to AVM - avoided and preserved during subsequent treatmentAVMHospital of the University

12、of Pennsylvaniaauditory receptionfMRI用于手術(shù)計(jì)劃系統(tǒng)聽(tīng)覺(jué)中樞反射區(qū)MRI技術(shù)進(jìn)展及臨床應(yīng)用17AVM Patient presenting with A Provides the capability to obtain the apparent diffusion coefficient of underlying tissue and exp (-b*ADC) to eliminate/reduce T2-shine through effectsFLAIRDWIexp. ADCADC Mapping - FuncTool99MRI技術(shù)進(jìn)展及臨床應(yīng)用1

13、8FLAIRDWIexp. ADCADC Mapping - Diffusion Tensor Imaging T2 + 6 diffusion directions anisotropy map - visualize white matter tracts True isotropic diffusion imageDiffusionTensor ImagingT1-PostFLAIRADCRelativeAnisotropyImage Courtesy of Dr. Tsuruda, University of UtahMRI技術(shù)進(jìn)展及臨床應(yīng)用19 Diffusion Tensor Im

14、aging DiffClinical Applications of Real-time fMRIImage Courtesy of Dr. Jackson, Dr. Sawaya, Dr. LeedsMD Andersen Cancer Center, HoustonSurgical PlanningLeft-handfinger tappingMRI技術(shù)進(jìn)展及臨床應(yīng)用20Clinical Applications of Real-功能性MRI(fMRI) 心臟功能性MRI利用心臟灌注脈沖序列可在極短時(shí)間(20s)內(nèi)實(shí)時(shí)顯示一系列心肌灌注信息。可顯示和計(jì)算一系列心臟的形態(tài)學(xué)和功能信息，如心壁

15、運(yùn)動(dòng)、流速測(cè)量、粥樣斑塊特征、左室功能(全部、局部)、動(dòng)態(tài)心功能(與靜態(tài)對(duì)比)等。冠狀動(dòng)脈高分辨率3D螺旋MRA，可和灌注成像技術(shù)互相補(bǔ)充。MRI技術(shù)進(jìn)展及臨床應(yīng)用21功能性MRI(fMRI) 心臟功能性MRIMRI技術(shù)進(jìn)展及臨Speed, Performance and Reliability Dedicated CardioVascular MR Ultrafast Techniques Tissue Characterization Coronary Myocardial Perfusion Detection of Infarct Time resolved MR angio Vess

16、el Wall Imaging Interactive real time Flow quantificationMRI技術(shù)進(jìn)展及臨床應(yīng)用22Speed, PerformanceDedicated CECG-Gated Double IR FSEAddenbrookes Hosp., Cambridge, UKMRI技術(shù)進(jìn)展及臨床應(yīng)用23ECG-Gated Double IR FSEAddenbrMR High resolution image of aortic valveCardiac MorphologyAortic valve imagingECG-gated black blood

17、FSEBlood & fat suppressed using Dbl/Trpl IRHigh resolution images of aortic valve, comparable to EchoNHLBI,GEMSEpstein et al.Echocardiography image of aortic valveMRI技術(shù)進(jìn)展及臨床應(yīng)用24MR High resolution image of aoThe most powerful system in the industry MRI技術(shù)進(jìn)展及臨床應(yīng)用25The most powerful system in thClinical

18、 MR Ventricular Function / MorphologyLCE-NHLBI 16 sec breath-hold Full R-R coverage High spatial and temporal resolutionFASTCINEMRI技術(shù)進(jìn)展及臨床應(yīng)用26Clinical MR Ventricular FunctiAortic DissectionAortic DiseaseCambridge UniversityBlack blood FSEMRI技術(shù)進(jìn)展及臨床應(yīng)用27Aortic DissectionAortic DiseasExcellent Soft Tis

19、sue Contrast for Tissue CharacterizationKerckhoff Heart Klinik, GermanyIdentification of fatty infiltration in the infarcted regionfat suppressedT1 breathholdMRI技術(shù)進(jìn)展及臨床應(yīng)用28Excellent Soft Tissue ContrastExcellent Myocardial DefinitionNew techniqueClear delineation of myocardiumHigh blood signalHalf t

20、he scan timeMRI技術(shù)進(jìn)展及臨床應(yīng)用29Excellent Myocardial DefinitioUltrafast Imaging of the Coronaries2D breathhold3D breathholdMRI技術(shù)進(jìn)展及臨床應(yīng)用30Ultrafast Imaging of the Coro3D BreathholdLeft CoronaryRight CoronaryAortic RootLeft CircumflexMRI技術(shù)進(jìn)展及臨床應(yīng)用313D BreathholdLeft CoronaryRighLeft Coronary Artery StenosisU

21、niversity Hospital, RotterdamConventional Angiography3D Breathhold MRAVolume RenderedMRI技術(shù)進(jìn)展及臨床應(yīng)用32Left Coronary Artery StenosisUKerckhoff Heart Klinik, GermanyClear Visualization of the Coronaries2D Breathhold: 10 sec2D Breathhold TSEMRI技術(shù)進(jìn)展及臨床應(yīng)用33Kerckhoff Heart Klinik, GermanCoronary MR Angiograp

22、hywithout contrast agentERESA Imaging Center, Valencia, SpainMRI技術(shù)進(jìn)展及臨床應(yīng)用34Coronary MR AngiographywithoutCoronary MR AngiographyUltrafast 3D imaging in 23 seconds Northwestern University, ChicagoMRI技術(shù)進(jìn)展及臨床應(yīng)用35Coronary MR AngiographyUltrafaHigh Speed Coronary MRA Northwestern University, ChicagoUltra

23、fast 3D imaging in 23 secondsMRI技術(shù)進(jìn)展及臨床應(yīng)用36High Speed Coronary MRA Northw Myocardial Perfusion First Pass Dynamic ImagingSubsecond imaging Following IV injectionA bolus of contrast agentPerfusion deficit seenpre-contrastMRI技術(shù)進(jìn)展及臨床應(yīng)用37 Myocardial Perfusion FDynamic first-pass perfusionBreathhold T2pr

24、e-contrastPatient with SubendocardialInfarctLesion Detection and Myocardial PerfusionMRI技術(shù)進(jìn)展及臨床應(yīng)用38Dynamic first-pass perfusionBrStenosis in a branch vesselof the circumflex coronary arteryMyocardial Viabilityfast and robustdetection of infarctsNorthwestern University, ChicagoWall Motion StudyViabil

25、ity StudyMRI技術(shù)進(jìn)展及臨床應(yīng)用39Stenosis in a branch vesselMyoReal Time ImagingInteractivity True flexibilitywithout ECG triggeringfree breathingMRI技術(shù)進(jìn)展及臨床應(yīng)用40Real Time ImagingInteractivity磁共振血管成像(MRA)對(duì)比增強(qiáng)MRA：有釓劑自動(dòng)密度跟蹤軟件。此外非釓劑對(duì)比劑增強(qiáng)MRA，可對(duì)比劑在血管內(nèi)廓清時(shí)間長(zhǎng)達(dá)2小時(shí)。短TE技術(shù)，TE時(shí)間已從過(guò)去2-3ms減少到0.6ms。提高成像與重建速度：可作實(shí)時(shí)或近于實(shí)時(shí)成像，做期相精確的

26、動(dòng)態(tài)MRA。大矩陣采集：提高M(jìn)RA對(duì)小血管的分辨能力，使用10242甚至20482矩陣原始影像的采集。MRI技術(shù)進(jìn)展及臨床應(yīng)用41磁共振血管成像(MRA)對(duì)比增強(qiáng)MRA：有釓劑自動(dòng)密度跟蹤軟磁共振血管成像(MRA)薄層塊多層塊重疊采集伴偽影抑制技術(shù)：消除MOTSA技術(shù)的階梯狀輪廓，重建更自然的血管影像。步進(jìn)MRA：類(lèi)似DSA步進(jìn)方式的分段成像并進(jìn)行拼接，得到完整的下肢血管影像。4D與血管內(nèi)窺鏡顯示：關(guān)于4D的概念不盡一致，有解釋為增加了時(shí)間軸；另有解釋為在3D的基礎(chǔ)上增加了血管透明化的顯示技術(shù)。血管內(nèi)窺鏡則是在各種MR內(nèi)窺鏡技術(shù)中難度較大的技術(shù)，尤其是在小的、搏動(dòng)性的血管。MRI技術(shù)進(jìn)展及臨床

27、應(yīng)用42磁共振血管成像(MRA)薄層塊多層塊重疊采集伴偽影抑制技術(shù)：高分辨率 MRA1024 ZIP 提供比1024采集更短的掃描時(shí)間和更小的信噪比損失 3DTOF MRA512, 1024 ZIP2x, 4x Through-plane ZIPImproves Apparent Resolution1024 ZIP重建技術(shù) - 3DTOF/FGREMRI技術(shù)進(jìn)展及臨床應(yīng)用43高分辨率 MRA3DTOF MRA1024 ZIP重建技術(shù) Enhanced 3DTOF512x192, thru-plane ZIP45/6.9 TR/TE, 20 x20 FOV120 SLICES, 9:17MRI

28、技術(shù)進(jìn)展及臨床應(yīng)用44Enhanced 3DTOF512x192, thru-plimagingvolumeTrackervolume 智能化造影劑全自動(dòng)跟蹤 SmartPrep 跟 蹤 區(qū) 掃 描 區(qū)MRI技術(shù)進(jìn)展及臨床應(yīng)用45imagingTracker 智能化造影劑全自動(dòng)跟蹤 Sm智能化造影劑自動(dòng)跟蹤SmartPrepMRI技術(shù)進(jìn)展及臨床應(yīng)用46智能化造影劑自動(dòng)跟蹤SmartPrepMRI技術(shù)進(jìn)展及臨床應(yīng)High Resolution Imaging of Vessel Wall400 micronresolution3D volume renderingCleveland Clinic

29、MRI技術(shù)進(jìn)展及臨床應(yīng)用47High Resolution Imaging of Ves3D Pulmonary MR Angiography3D volumetric imaging in 3 seconds unbeatable in the industry!MRI技術(shù)進(jìn)展及臨床應(yīng)用483D Pulmonary MR Angiography3DTime Resolved 3D MR AngiographyVisualizes contrast arrival in 3Dfollowing contrast injectionMRI技術(shù)進(jìn)展及臨床應(yīng)用49Time Resolved 3D M

30、R AngiographSuper Fast Scans: 4D-Imagingtime3D + temporal informationMRI技術(shù)進(jìn)展及臨床應(yīng)用50Super Fast Scans: 4D-Imagingti3D Carotid MRA in 9 secs Panoramic array coil for extended coverage MRI技術(shù)進(jìn)展及臨床應(yīng)用513D Carotid MRA in 9 secs Panor正常門(mén)脈、腸系膜上靜脈FL3d 3.15/1.23, FA=25度，1.5mm, 64層，230*256， BW=490，TA=16s, MIP Su

31、bMIPMRI技術(shù)進(jìn)展及臨床應(yīng)用52正常門(mén)脈、腸系膜上靜脈FL3d 3.15/1.23, FA=門(mén)脈高壓，靜脈曲張MRI技術(shù)進(jìn)展及臨床應(yīng)用53門(mén)脈高壓，靜脈曲張MRI技術(shù)進(jìn)展及臨床應(yīng)用53 Moving TablePeripheral MR AngiographySingle Injection for 3 Stationscourtesy of Dr. Terwey, BremenMRI技術(shù)進(jìn)展及臨床應(yīng)用54 Moving TablePeripcourtesy of Dr. Terwey, BremenPeripheral MRA MRI技術(shù)進(jìn)展及臨床應(yīng)用55courtesy of Dr.

32、Terwey, BremenMR設(shè)備軟件功能的發(fā)展超極化氣體MRI(MR Imaging with hyperpolarized gas)：讓病人吸入3氦(Helium-3)或129碘(Iodine-129)可使組織的磁性提高10倍。提高肺部的磁性100倍(因?yàn)榉蝺?nèi)含空氣，無(wú)氫質(zhì)子，原無(wú)信號(hào))，因此可施行MR肺成像(lung imaging)，取得了一定的臨床效果。正逐步拓寬臨床應(yīng)用范圍。使氣體能隨血流進(jìn)入腦內(nèi)而不大幅度衰減，可望應(yīng)用于腦部疾病等。MRI技術(shù)進(jìn)展及臨床應(yīng)用56MR設(shè)備軟件功能的發(fā)展超極化氣體MRI(MR ImagingMR設(shè)備軟件功能的發(fā)展螺旋MRI：是指利用K-空間行螺旋采集

33、而提高空間分辨力和聚焦速度的MRI方式，主要用于MR血管成像?，F(xiàn)在，此采集方式可在檢查中實(shí)時(shí)改變?nèi)齻€(gè)軸向的位置和梯度場(chǎng)切換率，從而可適于心血管、冠狀動(dòng)脈及活檢檢查等范疇的應(yīng)用。MRI技術(shù)進(jìn)展及臨床應(yīng)用57MR設(shè)備軟件功能的發(fā)展螺旋MRI：是指利用K-空間行螺旋采集MR設(shè)備軟件功能的發(fā)展超聲MRI：MRI與US聯(lián)合應(yīng)用的一種方式，最終完成3D顯示。預(yù)極化MRI(MR Imaging with prepolariztion)： 處于設(shè)想階段。該技術(shù)今后若能成功將會(huì)大為降低MR設(shè)備的費(fèi)用(低場(chǎng)MR獲高場(chǎng)設(shè)備的信噪比)，此種設(shè)備是否能成為現(xiàn)事尚待觀察。MRI技術(shù)進(jìn)展及臨床應(yīng)用58MR設(shè)備軟件功能的發(fā)展

34、超聲MRI：MRI與US聯(lián)合應(yīng)用的一種MR設(shè)備軟件功能的發(fā)展MRI在胃腸道的應(yīng)用和CT一樣，MRI對(duì)于消化管的顯示長(zhǎng)期以來(lái)一直是相對(duì)盲區(qū)，但目前MRI的一個(gè)應(yīng)用突破是對(duì)小腸與結(jié)腸病變的顯示。結(jié)合腸腔內(nèi)灌注釓劑后使用特殊的序列采集，如3DSPGR與T2加權(quán)SSPSE，再配合4D顯示、MR內(nèi)窺鏡及多平面重建等技術(shù)顯示腸壁與腸腔內(nèi)病變。據(jù)報(bào)道，大于5mm結(jié)腸息肉，MRI的敏感性與特異性均可達(dá)到90%以上。MRI技術(shù)進(jìn)展及臨床應(yīng)用59MR設(shè)備軟件功能的發(fā)展MRI在胃腸道的應(yīng)用MRI技術(shù)進(jìn)展及臨 臨床應(yīng)用 MRI技術(shù)進(jìn)展及臨床應(yīng)用60 臨床應(yīng)用 MRI技術(shù)進(jìn)展及臨床應(yīng)用60MR設(shè)備軟件功能的發(fā)展MRI在

35、腹部應(yīng)用的進(jìn)展肝臟成像：對(duì)比劑已有三類(lèi)：A.細(xì)胞外對(duì)比劑，如Gd-DTPA，有助與顯示富血管病變，如原發(fā)性肝癌；B.組織特異性對(duì)比劑，如氧化鐵顆粒，可用于區(qū)分肝實(shí)質(zhì)與轉(zhuǎn)移性病變；C.肝膽對(duì)比劑，也是組織特異性對(duì)比劑，可在T1加權(quán)影像上提供長(zhǎng)時(shí)間的實(shí)質(zhì)強(qiáng)化，有助于鑒別肝臟占位，如腺瘤、局灶性結(jié)節(jié)樣增生及低分化肝細(xì)胞癌等。MRI技術(shù)進(jìn)展及臨床應(yīng)用61MR設(shè)備軟件功能的發(fā)展MRI在腹部應(yīng)用的進(jìn)展MRI技術(shù)進(jìn)展及MR設(shè)備軟件功能的發(fā)展MRI在腹部應(yīng)用的進(jìn)展MR膽胰管成像(MRCP)：A.識(shí)別解剖學(xué)變異，如胰腺分裂和囊性胰管損傷；B.證實(shí)膽道梗阻的存在，明確阻塞部位和范圍和梗阻原因；C.識(shí)別惡性病變，如膽管癌(但不能識(shí)別壺腹癌)等；D.胰管成像；E.評(píng)價(jià)功能，如對(duì)縮膽囊素的反應(yīng)；F.術(shù)后評(píng)價(jià)。胰腺：MRI目前可用于識(shí)別胰島細(xì)胞癌和小胰管癌，鑒別慢性胰腺炎與胰腺癌等。腹膜：MRI用于腹膜疾病的診斷，高度敏感，但特異性較差。MRI技術(shù)進(jìn)展及臨床應(yīng)用62MR設(shè)備軟件功能的發(fā)展MRI在腹部應(yīng)用的進(jìn)展MRI技術(shù)進(jìn)展及膽總管下端嵌頓結(jié)石MRI技術(shù)進(jìn)展及臨床應(yīng)用63膽總管MRI技術(shù)進(jìn)展及臨床應(yīng)用63胰頭癌FS-Fl2d-T1WI HASTE-T2WI MRI技術(shù)進(jìn)展及臨床應(yīng)用64胰頭癌FS-Fl2