磁共振成像对胰腺癌与肿块型胰腺炎的诊断中的应用  

Diagnostic value of magnetic resonance imaging for pancreatic cancer,lump type pancreatitis

作　　者：黄瑞瑜[1] 赵仁军 许保刚[1] 马杏芝 喻霞[1] 

机构地区：[1]陕西中医学院第二附属医院磁共振室 [2]咸阳铁20局医院功能科B超室,陕西咸阳712000

出　　处：《临床和实验医学杂志》2016年第3期284-286,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨磁共振成像(MRI)对胰腺癌、肿块型胰腺炎的诊断价值。方法回顾性分析经病理证实的胰腺癌32例、肿块型胰腺炎30例患者、胰腺正常受检者30例的MRI资料,所有受检者均行常规MRI系列、DWI扫描及动态增强扫描,比较三组患者MRI影像学表现、DWI值及时间信号强度曲线(TIC)。结果 1胰腺癌T1WI病灶多呈低信号,部分病灶为等信号或混杂信号,T2WI多呈稍高信号;肿块型胰腺炎T1WI上多呈等、低信号,T2WI多呈不均匀稍高信号或等信号;2DWI序列胰腺癌组28例呈高信号,肿块型胰腺炎均呈稍高信号;胰腺癌ADC值显著高于肿块型胰腺炎,低于正常胰腺,差异有统计学意义(P<0.05),肿块型胰腺炎ADC值显著低于正常胰腺,差异有统计学意义(P<0.05);3胰腺癌组TIC曲线以缓升平台型为主,占84.36%,肿块型胰腺炎以缓升缓降型为主,占73.33%,正常胰腺组以速升速降型为主,占100%,三组TIC曲线比较差异有统计学意义(P<0.05)。结论 MRI DWI序列及动态增强扫描对胰腺癌与肿块型胰腺炎的鉴别诊断具有显著价值。Objective To investigate the diagnostic value of magnetic resonance imaging（ MRI） for pancreatic cancer,lump type pancreatitis. Methods MRI data of 32 cases of patients with pathologically proved pancreatic cancer,30 cases of patients with mass type chronic pancreatitis,30 cases with normal pancreas were analyzed. All subjects underwent conventional MRI series,DWI scan and dynamic enhanced scanning,to compare MRI imaging,DWI value and the signal strength and time curve（ TIC） in the three groups of patients. Results 1The T1 WI of pancreatic cancer lesions showed low signal,partial lesion was isointense or mixed signal. T2 WI showed slightly higher signal. T1 WI lump type pancreatitis showed isointense,low signal. T2 WI showed the heterogeneous hyperintense signal or isointense signal. 2The DWI sequence in 28 cases of pancreatic cancer group showed high signal,lump type pancreatitis were slightly high signal. ADC value in the pancreatic cancer was obviously higher than the lump type pancreatitis,lower than that of normal pancreas,the difference was statistically significant（ P〈0. 05）. ADC value in the mass type pancreatitis was significantly lower than that of normal pancreas,the difference was statistically significant（ P〈0. 05）. 3TIC curve in the pancreatic cancer group showed slow rising platform type,accounting for 84. 36%,lump type pancreatitis showed slow rise and slow drop type,accounting for 73. 33%,the normal pancreas group showed fast rise and fall type,accounting for 100%,there was significant difference between three groups（ P〈0. 05）. Conclusion DWI sequences and dynamic enhanced scanning of MRI has a significant value in differential diagnosis of pancreatic carcinoma and chronic pancreatitis.

关 键 词：胰腺癌 肿块型胰腺炎 磁共振成像 DWI值 时间信号强度曲线 

分 类 号：R735.9[医药卫生—肿瘤] R576[医药卫生—临床医学] R445.2