呼吸触发磁共振扩散加权成像在胰腺导管腺癌诊断中的应用价值  

Value of respiratory triggered diffusion weighted magnetic resonance imaging in the diagnosis of pancreatic adenocarcinoma

作　　者：刘莉[1] 马超[1] 李晶[1] 李延军[1] 潘春树[1] 康钦钦[1] 陈录广[1] 陈士跃[1] 陆建平[1] 

机构地区：[1]第二军医大学长海医院放射科,上海200433

出　　处：《中华胰腺病杂志》2015年第1期14-17,共4页Chinese Journal of Pancreatology

基　　金：长海医院“1255”学科建设计划（CHl25520800）;长海医院青年科研启动基金（2013002）

摘　　要：目的探讨呼吸触发磁共振扩散加权成像（RTDWI）诊断胰腺导管腺癌的价值。方法前瞻性对病理证实的54名胰腺导管腺癌患者及49名胰腺正常的健康志愿者行上腹部呼吸触发单次激发平面回波DWI（b值为0、600s／mm^2），计算及测量正常胰腺头、体、尾部的表观扩散系数（ADC）值和胰腺癌的ADC值。采用独立样本非参数Mann-WhitneyU检验比较胰腺癌组与正常胰腺组（头、体及尾部）ADC值的差异，并用受试者工作特征曲线下面积（AUC）分析以正常胰腺不同部位ADC值为依据诊断胰腺导管腺癌的效能。结果正常胰腺头、体、尾部ADC值分别为（1．66±0．34）、（1．77±0．36）、（1．62±0．38）×10^-3mm^2／s，胰腺癌平均ADC值为（1．36±0．14）×10^-3mm^2／s，胰腺癌与正常胰腺不同部位的差异均具有统计学意义（P值均为0．000）。分别以正常胰腺头、体、尾部ADC值为依据，胰腺癌的AUC分别为0．767、0．889、0．737。以正常胰体部ADC为依据，ADC≤1．485×10^-3mm^2／s作为诊断胰腺癌的临界值的敏感度和特异度分别为83．7％和81．5％。结论RTDWI对胰腺导管腺癌有较好的诊断价值，以正常胰腺体部ADC值作为对照是最佳选择。Objective To investigate the value of respiratory triggered diffusion weighted magnetic resonance imaging （RT DWI） in the diagnosis of pancreatic adenocarcinoma. Methods Fifty-four patients with histologically confirmed pancreatic ductal adenocarcinoma and 49 healthy volunteers with normal pancreas underwent RT DWI at 3.0 T （ b-values = 0, 600 s/mm^2 ） in a prospective manner. Apparent diffusion coefficient （ADC） values of normal pancreas head, body and tail as well as ADC values of the pancreatic adenocarcinoma were measured and calculated. The ADC values between the different anatomical regions of normal pancreas and pancreatic adenocarcinoma were analyzed by using Mann-Whitney U test. Receiver- operating characteristic （ ROC ） curve analyses were used to determine the diagnostic performances of ADCs to distinguish pancreatic adenocarcinoma from normal pancreas. Results The ADC values were （ 1.66 ± 0.34）, （1.77±0.36） and （1.62 ±0.38） × 10^-3 mm^2/s in normal pancreas head, body and tail, and the ADC value of pancreatic adenocarcinoma was （ 1.36 ± 0.14 ） × 10 ^-3 mm^2/s, and the ADC values differed significantly between pancreatic adenocarcinoma and normal pancreas （P 〈0.000 ）. With the ADC values of normal pancreatic head, body and tail as references, the areas under the curve （AUC） were 0.767, 0. 889 and 0.737, respectively. The sensitivity and specificity were 83.7% and 81.5%, respectively, when ADC≤ 1. 485 × 10 ^-3 mm^2/s was used as the cut off value for differential diagnosis of pancreatic adenocarcinoma from normal pancreas body. Conclusions RT DWI has a better diagnostic accuracy in the diagnosis of pancreatic ductal adenocarcinoma. The ADC value of normal pancreas body is recommended as a control.

关 键 词：胰腺肿瘤 磁共振成像 弥散 呼吸触发 对比研究 

分 类 号：R735.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]