MR DWI对急性胰腺炎的诊断价值  

Diagnostic value of magnetic resonance diffusion weighted imaging in acute pancreatitis

作　　者：陈伯柱 何健[1] 沈珊珊[2] 谢颖[2] 俞海平[1] 李茗[1] 刘松[1] 王雷[2] 周正扬[1] 

机构地区：[1]南京医科大学鼓楼临床医学院影像科,江苏南京210008 [2]南京医科大学鼓楼临床医学院消化科,江苏南京210008

出　　处：《实用放射学杂志》2017年第3期408-411,共4页Journal of Practical Radiology

摘　　要：目的 探讨MR扩散加权成像（DWI）对急性胰腺炎（AP）的诊断价值.方法 回顾性分析50例AP及75例正常胰腺的MR资料,计算DWI序列b=800 s/mm2图像上胰腺与肝脏的信号强度比（SIR）,测量胰腺的表观扩散系数（ADC）,分别比较2组的SIR及ADC,并根据受试者工作特征（ROC）曲线确定最佳诊断阈值,评价SIR、ADC与MRI常规序列的诊断效能.结果 与正常胰腺相比,AP组SIR显著升高（2.06±0.48 vs 1.24±0.27,t=12.2,P〈0.0001）,ADC显著降低[（991±133）μm^2/s vs（1153±149）μm^2/s,t=-6.2,P〈0.0001].最佳诊断阈值分别为SIR〉1.51、ADC≤1039μm^2/s.SIR的敏感度（92.0%）高于ADC（72.0%）及MRI常规序列（74.0%）,SIR（88.0%）及MRI常规序列（93.3%）的特异度高于ADC（77.3%）.结论 AP时水分子扩散受限,SIR诊断效能优于ADC及MRI常规序列,有利于AP的检出.Objective To evaluate the diagnostic value of magnetic resonance （MR）diffusion weighted imaging （DWI）in the de-tection of acute pancreatitis （AP）.Methods Pancreas to liver signal intensity ratios （SIR）on DWI b=800 s/mm^2 images and pan-creatic apparent diffusion coefficient （ADC）values were retrospectively measured and compared between 50 patients with AP and 75 patients with normal pancreas （NP）.Receiver operating characteristic （ROC）analysis was used to determine the cut-off values.The sensitivity and specificity of SIR,ADC and routine MRI were compared.Results Compared to NP,AP revealed significantly higher SIR （2.06±0.48 vs 1.24±0.27,t=12.2,P〈0.0001）and lower ADC [（991±133）μm^2/s vs （1153±149）μm^2/s,t=-6.2,P〈0.0001）].A threshold of SIR〉1.51 and ADC≤1039 μm^2/s yielded the best cut-off value.The sensitivity of SIR （92.0%）was higher than ADC （72.0%）and routine MRI（74.0%）.The specificity of SIR （88.0%）and routine MRI（93.3%）was higher than ADC （77.3%）.Conclusion AP demonstrates restricted diffusion.SIR has higher diagnostic value than ADC and routine MRI for the detection of AP.

关 键 词：急性胰腺炎 磁共振成像 扩散加权成像 

分 类 号：R576[医药卫生—消化系统] R445.2[医药卫生—内科学]