胰腺癌与慢性胰腺炎MRI诊断临床应用价值的研究  

A study of the clinical value of MRI diagnosis on pancreatic carcinoma and chronic pancreatitis

作　　者：张肇惠[1] 刘海明[2] 滕坤[1] 王阿樱[1] 

机构地区：[1]哈尔滨医科大学第二临床医学院MRI室 [2]解放军211医院,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2006年第6期498-501,共4页Journal of Harbin Medical University

摘　　要：目的通过胰腺癌与慢性胰腺炎MRI诊断与鉴别诊断的回顾性研究,为探讨MRI对胰腺癌与慢性胰腺炎诊断的准确性及其临床应用价值。方法对32例胰腺癌,25例慢性胰腺炎进行MRI检查,对MRI征象进行观测,统计与分析。检查方法包括平扫T1WI,T2WI,MRCP,动态增强前后的脂肪抑制T1WI。结果二者诊断与鉴别诊断的主要征象是:①病变区胰腺局限或弥漫肿大与信号异常;②有无扩张的胆总管突然性狭窄截断与胰周大血管包埋、管径增粗、癌栓、腹部淋巴结肿大、肝转移;③胰腺囊肿的发生频率、部位,与胰腺轮廓的关系;④有无扩张胰管,扩张胰管的形态与贯穿病变区的情况,有无沿胰管走向分布的钙化(结合CT)。结论由于MRI无辐射及新的实用技术(MRCP,动态增强扫描及细胞特异性对比剂等)的应用,使MRI成为胰腺疾病重要的检查手段,具有较高的临床应用价值。Objective To evaluate the accuracy of MRI diagnosis and its clinical value by retrospective research of MRI diagnosis and differential diagnosis between pancreatic carcinoma and chronic pancreatitis. Methods the MRI findings of 32 cases with pancreatic carcinoma and 25 cases with chronic pancreatitis were analyzed, The MRI techniques included： unenhanced FLASH T1WI, unenhanced FS FLASH TIWI, HASTE T2WI, MR （MRCP） and multiphase dynamic enhanced FS FLASH T1WI. Results The main signs in diagnosis and differential diagnosis between pancreatic carcinoma and chronic pancreatitis included：（1）focal or diffuse enlargement and signal intensity abnormality of pancreas;（2）dilated common bile duct was suddenly obstructed, peripancreatic blood vessels were invaded and cancerous thrombus were revealed, enlargement of abdominal lymph nodes and metastasis in the liver were discovered; （3） presence and location of pancreatic cyst and its relationship to pancreatic contour; （4）calcium deposit in the pancreatic duct area, dilated pancreatic duct which passed through the lesion or not（connected with CT）. Conclusion No radiation and the use of new practical approach make MRI become an important detecting means for pancreatic diseases,so it is getting better clinical value.

关 键 词：MRI 磁共振胰胆管水呈像 胰腺癌 慢性胰腺炎 

分 类 号：R817.4[医药卫生—影像医学与核医学]