Peri-pancreatic Lymphatics : Evaluation with 3. 0T MR imaging(fat-suppressed T2-weighted images with a three-dimensional spectral pre-saturation with inversion recovery volume isotropic turbo spin echo acquisition)

目的对腹骨盆淋巴管的详细解剖研究仅在尸体上进行。胰胆管淋巴管的磁共振成像尚未见报道。本研究的目的是评估正常胰胆管淋巴的可视性。0-T MR成像。材料与方法对27例怀疑为肝脏或胰胆管疾病，经病理诊断为良性病变的患者进行回顾性分析。G，肝囊肿，肝血管瘤)被评估为胰胆管淋巴正常的受试者。磁共振成像方案包括脂肪抑制的t2加权图像，三维光谱预饱和，反演恢复体积各向同性涡轮自旋回波采集（SPIR VISTA）。胰头及肝十二指肠韧带周围淋巴管分为8段，便于图像解释。每个部分的可见性由2名观察员根据预先定义的标准在5点置信度上独立评估。通过Kappa统计评估观察者间的一致性。最后的意见是一致通过的。结果各节段的显像率分别为：前上段显像率100%，前中段显像率89%，前下段显像率85%，后上、中、下段及乳糜动脉与肠系膜上动脉之间右侧显像率100%，肝十二指肠韧带周围显像率96%。观察员间达成了良好或优秀的协议。结论SPIR - VISTA三维脂肪抑制t2加权图像能充分显示正常情况下的胰胆管淋巴。

PurposeDetailed anatomy of abdominopelvic lymphatics has been studied only in cadavers. There is no report regarding the MR imaging of pancreatobiliary lymphatics. The purpose of this study was to assess the visibility of normal pancreatobiliary lymphatics on 3. 0-T MR imaging.Materials and MethodsTwenty-seven patients who were suspected of hepatic or pancreatobiliary diseases and diagnosed as benign pathologies(e. g., hepatic cysts, hepatic hemangioma) were evaluated as subjects having normal pancreatobiliary lymphatics. The MR imaging protocol consisted of fat-suppressed T2-weighted images with a three-dimensional spectral pre-saturation with inversion recovery volume isotropic turbo spin echo acquisition(SPIR VISTA). For image interpretation, the lymphatics surrounding the pancreatic head and hepatoduodenal ligament were divided into eight segments. Visibility of each segment was rated independently by 2 observers according to predefined criteria on a 5-point confidence scale. Interobserver agreement was assessed by Kappa statistics. The final opinion was reached by consensus.ResultsEach segment was visualized as follows : 100% of the anterior upper portion, 89% of the anterior middle portion, 85% of the anterior lower portion, 100% of the upper and middle to lower posterior portions as well as the right side portion between the celiac and superior mesenteric arteries, and 96% of the surrounding area of the hepatoduodenal ligament. Good or excellent interobserver agreement was determined.ConclusionPancreatobiliary lymphatics under normal conditions could be sufficiently visualized on fat-suppressed T2-weighted images with a three-dimensional SPIR VISTA.