MRI3D-VIBE序列对胰腺癌的诊断价值和手术可切除性的评价  

Evaluation of MR Diagnostic Value and Resectability in Pancreatic Carcinoma with Contrast-Enhanced Multi-Phasic Isotropic Volumetric Interpolated Breath-Hold Examination

作　　者：王静[1] 高磊[2] 武乐斌[1] 陆建平[3] 

机构地区：[1]山东省医学影像学研究所,济南250021 [2]山东省肿瘤医院,250117 [3]上海长海医院放射科,200433

出　　处：《临床放射学杂志》2007年第8期791-794,共4页Journal of Clinical Radiology

摘　　要：目的探讨MRI三维容积插入法屏气扫描(3D VIBE)序列多期增强扫描对胰腺癌的诊断价值和手术可切除性评价。资料与方法30例胰腺癌常规MRI平扫后行动态增强扫描12例二维快速小角度激发成像(2D FLASH),18例3D VIBE序列。测量增强后胰腺-病灶的信号值,计算对比噪声比(CNR);采用双盲法判断胰腺癌周围浸润及转移情况,评价肿瘤可切除性并与手术病理结果进行比较。结果3D VIBE增强后各期胰腺-病灶的CNR均高于2D FLASH序列,尤以胰腺实质期明显且相差显著;VIBE序列显示邻近器官受侵、胰周血管受累及转移灶检出的敏感性及准确性均高于后者,其判断胰腺癌手术可切除性的准确性亦高于2D FLASH序列。结论3D VIBE序列多期增强扫描可显示肿瘤的解剖细节及血液动力学特征,结合三维重组技术可提高手术可切除性评价,对术前手术方案的制定有指导意义。Objective To discuss the diagnostic value and resectability in pancreatic carcinoma with multi - phasic isotropic volumetric interpolated breath -hold examination （VIBE）. Materials and Methods 30 patients with pancreatic carcinoma performed MR plan and multi -phasic contrast -enhanced examination（2D FLASH for 12 patients ,3D VIBE for 18 patients）. Mean signal intensities of normal pancreas and pancreatic carcinoma were measured to compute the CNR and results were performed statistical analysis. Evaluation of carcinoma resectability with 2D and 3D group were assessed by double -blind method and compared with surgical and pathological results. Results The CNR of the pancreas versus pancreatic -carcinoma in 3D group were higher than that in 2D group,especially in pancreatic phase （p 〈0. 05）, 3D VIBE showed that the sensitivity and accuracy of extrapancreatic tumor spread, vascular involvement, liver metastases was higher than that in 2D FLASH group. The accuracy for resectability was also higher than that in 2D FLASH group. Condusion 3D VIBE multiphase enhancement examination can provide anatomic details and the hemodynamic features of pancreatic carcinoma. Combining with three - dimension reconstruction technique, 3D VIBE can improve assessment of resectability of pancreatic carcinoma,which can significantly contribute to preoperative planning.

关 键 词：胰腺癌 磁共振成像 三维重组 

分 类 号：R735.9[医药卫生—肿瘤]