三維磁振膽道胰管攝影術：比較呼吸觸發技術與導航觸發技術的影像品質

3D MRCP Image Quality: Comparison between Respiratory Triggered Technique and Navigator Triggered Technique

杜家宏(Chia-Hung Tu) ； 謝志明(Chih-Ming Hsieh) ； 蔡昇宏(Sheng-Hung Tsai) ； 林宥閎(Yu-Hung Lin) ； 林怡里(Yi-Li Lin)

《中華放射線技術學雜誌》 40卷2期 (2016/06) Pp. 68-76

摘要

呼吸觸發技術（respiratory triggered technique）進行三維核磁共振膽胰管攝影（three dimensional magnetic resonance cholangiopancreatography, 3D MRCP）因為呼吸不穩定及躁動的影響而產生糟糕的影像，導航觸發技術（navigator triggered technique）的運用被期待能改善影像品質。本研究是比較呼吸觸發與導航觸發技術在三維核磁共振膽胰管攝影的影像品質。本研究使用1.5T 核磁共振儀（magnetic resonance imaging, MRI），從2014 年9 月至2015 年1 月間，共收集30 位案例。分別使用呼吸觸發與導航觸發技術來取得影像。影像獨立由兩位放射科醫師，針對影像的解剖結構（anatomy structure）、影像品質（image quality）、假影（artifact）以五級分評分，以成對T 檢定執行統計分析。結果，第一位放射科醫師在呼吸觸發及導航觸發技術各別評分，解剖結構（3.9±0.9/4.1±1.0; p=0.161）、影像品質（3.6±0.9/3.9±0.9; p=0.048）、假影（3.2±1.0/3.7±0.9; p=0.008）。第二位放射科醫師在呼吸觸發及導航觸發技術各別評分，解剖結構（3.9±0.9/4.0±1.0; p=0.541）、影像品質（3.8±0.9/4.2±0.9; p=0.043）、假影（3.6±0.9/4.1±0.8; p=0.010）。呼吸觸發及導航觸發技術都是偵測呼吸動作來產生影像，使用導航觸發技術更能夠改善呼吸不穩定及躁動的影響。導航觸發技術執行三維核磁共振膽胰管攝影的影像在解剖結構差異不大，但明顯改善影像品質與減少假影。結論，導航觸發技術在三維核磁共振膽胰管攝影能夠更準確偵測呼吸與橫膈膜的位置，取得更佳的影像品質。

關鍵字

三維核磁共振膽胰管攝影 ； 呼吸觸發技術 ； 導航觸發技術

並列摘要

Respiratory triggered technique of 3D magnetic resonance cholangiopancreatography (MRCP) easily made terrible image quality when patients breathed unstably and agitation. Navigator triggered technique was expected to improve image quality. The purpose of this study was to evaluate image quality in 3D MRCP that to compare with respiratory and navigator triggered technique. Magnetic resonance imaging (MRI) was performed with a 1.5T system (Optima 450W; GE Healthcare). From September 2014 to January 2015, thirty patients with suspected biliary pathology were evaluated with 3D MRCP using the respiratory and navigator triggered techniques. All images were evaluated independently by two radiologists. The conspicuity of the anatomy structure, image quality, and artifacts were evaluated on a 5-point scale. Statistical analysis was done by paired t-test. The scores of respiratory/navigator for the radiologist 1 were confirmed with anatomy structure (3.9±0.9/4.1±1.0; p=0.161), image quality (3.6±0.9/3.9±0.9; p=0.048), and artifacts (3.2±1.0/3.7±0.9; p=0.008). The scores of respiratory/navigator for the radiologist 2 were confirmed with anatomy structure (3.9±0.9/4.0±1.0; p=0.541), image quality (3.8±0.9/4.2±0.9; p=0.043), and artifacts (3.6±0.9/4.1±0.8; p=0.010). Navigator triggered 3D MRCP showed no significant differences on anatomy structure with respiratory triggered 3D MRCP. Navigator triggered technique improved image quality and reduced the artifacts, especially for respiratory and agitation artifact. We conclude that navigator triggered technique is more accurate to get the diaphragm movement than belt track respiration and show better image quality.

並列關鍵字

3D MRCP ； respiratory triggered technique ； navigator triggered technique