【正文】 40 Location 256X192 NEX Slice Thickness: mm (ZIP 2): 12 sec LAVA Arterial phase Late phase 3D Data Set Coronal Reformat Plane Coronal MIP Plane 腸系膜上動(dòng)脈 腹腔干 主動(dòng)脈矢狀最大強(qiáng)度投射 (MIP) 矢狀部分容積 MIP 橫斷重建 通過腹腔干及腸系膜上動(dòng)脈的橫斷圖像重建主動(dòng)脈的矢狀 MIP 腸系膜上動(dòng)脈 腹腔干 腸系膜下動(dòng)脈 Portal Vein Portalvenous ?Large dose GdDTPA？ FA=30？ ?Coverage ?Three phases ? Arterial ? Portal venous ? Equilibrium Arterial 門靜脈主干 腸系膜上靜脈 門靜脈主干 取完整 3D 容積之 MIP 取部分容積之 MIP 橫斷重建 取完整 3D 容積之 MIP 橫斷重建 取部分容積之 MIP 肝右靜脈 肝右靜脈 右腎動(dòng)脈 冠狀斜位 MIP 重建 橫斷面 橫斷斜位重建 右腎動(dòng)脈 右腎動(dòng)脈 右腎動(dòng)脈 三維外表面重建（ SSD） ： 利用視點(diǎn)追蹤線選擇可視體素（血管外輪廓），通過閾值技術(shù)將選擇的體素作為表面獲得的線折射算法重建圖像，這種圖像觀察的是血管外壁的立體輪廓，不能提供管腔內(nèi)信息。 仿真內(nèi)窺鏡表面重建（ VE） ： 以數(shù)學(xué)模擬方式對(duì)血管表面象素成像，利用調(diào)節(jié)閾值及視野，將超出閾值的象素作為等信號(hào)處理，使其不顯影，再應(yīng)用軟件的漫游功能沿血管壁進(jìn)行動(dòng)態(tài)觀察，其效果類似于血管于內(nèi)鏡檢查。 3D重建 3D重建 Navigator （二） 口服法 1. 釓噴酸 使用劑量： 5—10 mg / Kg， 開水稀釋 10倍 馬根維顯 （靜脈藥稀釋口服） —1 mg / Kg， 加水 10002022ml 適用于肝左葉病變、胃部病變及增加胰腺周圍對(duì)比。 右側(cè)位 伏臥位 俯臥位 MRI gastrography using the dark lumen technique (coronal T1w 3DFLASH). Tap water as oral contrast medium provides a black lumen (arrow). GdDTPA (Magnevist, Schering, Germany) iv results in a high signal of the gastric carcinoma (arrowhead). Lymph node metastases near the lesser curvature (arrow。 arrowhead pointing to the gastric corpus。 coronal T1w 3DFLASH, gastric carcinoma). Gastric carcinoma located in the lesser curvature. Without iv contrast, only a weak contrast between gastric carcinoma (arrow) and surrounding tissue is visible (axial T1w FLASH2D). B, Same patient as in A. The iv contrast (together with the black intraluminal signal provided by water) clearly depicts the gastric carcinoma (arrow) from its surrounding tissue (axial T1w 2DFLASH). 2. 造影劑：枸櫞酸鐵胺泡騰劑 每袋 3g (含 600mg枸櫞酸鐵胺 ), 加水 300ml口服 后 530分鐘掃描 適用于腹部、 MRCP等病變。 枸櫞酸鐵胺泡騰顆粒（ Ferrimage） 包裝： 3g： （鐵 129mg） 商品名： 復(fù)銳明 北陸藥業(yè) 枸櫞酸鐵胺泡騰顆粒（ Ferrimage） 順磁性對(duì)比劑 ,能同時(shí)縮短 T1和 T2馳豫時(shí)間 , T1 相表現(xiàn)為高信號(hào) , T2相表現(xiàn)為低信號(hào) ,是理想的 雙相對(duì)比劑 口服鐵劑吸收峰值在給藥后 24小時(shí) 用于腹部磁共振成像 ,對(duì)消化道 (胃 ﹑ 十二指腸 ﹑ 空腸 )進(jìn)行造影 增加胃腸道的分辨率，提供新的診斷信息 顯示胃腸道位置，確定病變與胃腸道及其鄰 近器官的位置關(guān)系 用于 MRCP、 MRU 檢查，排除胃腸道的液 體干擾 臨床應(yīng)用 膽囊炎及膽管炎 膽總管結(jié)石 沒有服用枸櫞酸鐵銨對(duì)比劑，背景不清晰； 服用枸櫞酸鐵銨對(duì)比劑后一個(gè)半小時(shí)掃描 膽總管多發(fā)結(jié)石顯示清楚 膽總管結(jié)石 膽囊、膽總管結(jié)石 3. 水 使用低張藥物如： 6542 一支 , 多喝水 適用于腹部胃腸道等病變。 （三） 灌腸法 同口服法，使用量約 1000ml。 病人體位采用側(cè)臥位，橡膠肛管經(jīng)直腸灌入。 適用于觀察直腸后窩周圍病變與前列腺、膀胱子宮等關(guān)系。 2. 直接注入空氣法 使用量約 100ml左右。 3. 直接注入水 (A) A 38 year old volunteer undergoing magic resonance colonography in conjunction with rectal application of water. The coronal source image of T1 weighted three dimensional GRE (TR/TE ) scan acquired prior to intravenous application of contrast medium shows moderate contrast between bowel wall and bowel lumen. (B) Coronal source images of the same volunteer acquired 75 seconds after intravenous administration of gadolinium. The colonic wall enhances brightly and can be easily delineated against the background of a dark water filled colonic lumen. (C) Transverse colon of the same volunteer. The colonic wall shows a normal thickness (2 mm) (arrow), contrast uptake (contrast to noise ratio 42), and number of haustral folds (14) (arrow). (A) T1 weighted three dimensional GRE image (TR/TE ) of a 55 year old male patient with known Crohn’s disease. Magic resonance colonography (MRC) visualised a slight inflammation in the descending colon based on an increase in contrast uptake and wall thickness and decrease in the number of haustral folds (arrow). This finding was confirmed by histopathology. (B) Detailed display of the transverse colon of the same patient. By means of MRC, the transverse colon was graded as normal (arrow). However, histopathology showed slight inflammation in the transverse colon. (A) T1 weighted three dimensional GRE image (TR/TE ) of a 47 year old male patient with known ulcerative colitis. Magic resonance colonography diagnosed an inflammation in the descending colon (arrow). (B) Detailed display of the descending colon of the same patient which displays loss of haustral markings and slight bowel wall thickening. Due to the absence of lymph nodes as well as normal contrast uptake in the colonic wall, inflammation was rated as slight. This was confirmed by subsequent endoscopy.