磁共振量化指标在十二指肠乳头部病变鉴别诊断中的应用价值  

The Application Value of Quantitative Magnetic Resonance Index in Differential Diagnosis of Benign and Malignant Lesions of Duodenal Papilla

作　　者：李晓清[1] 曾强[1] 富聪聪 郑慈娜[1] 聂苗苗[1] LI Xiaoqing;ZENG Qiang;FU Congcong(Department of Magnetic Resonance Imaging,Zhongshan Hospital Affiliated to Xiamen University,Xiamen,Fujian Province 361004,P.R China)

机构地区：[1]厦门大学附属中山医院磁共振科,361000

出　　处：《临床放射学杂志》2025年第5期898-902,共5页Journal of Clinical Radiology

摘　　要：目的探讨磁共振量化指标在鉴别十二指肠乳头部炎症、腺瘤与腺癌的价值。方法回顾性分析52例在本院经病理证实的十二指肠乳头部炎症、腺瘤和腺癌的MRI资料,测量十二指肠乳头部病变最大径、胆管最大径和十二指肠乳头病变最大径与胆管最大径比值,运用统计学分析三组数据在良恶性病变间的差异,有显著差异的组间数据运用约登指数法计算其特异度及敏感度。结果十二指肠病变最大径在三组间均无显著差异(P>0.05),胆管最大径及十二指肠乳头病变最大径与胆管最大径比值在腺癌与腺瘤组间及腺癌与炎症组间均有显著差异(P<0.05),其在腺瘤与炎症组间无显著差异(P>0.05),胆管最大径诊断界值为1.65cm,对应的敏感度为0.962,特异性为0.731,诊断准确率为91.6%;十二指肠乳头病变最大径与胆管最大径比值诊断界值为0.976,对应的敏感度为0.731,特异性为0.769,诊断准确率为81.5%。结论磁共振量化指标胆管最大径及十二指肠乳头病变最大径与胆管最大径比值可以有效地对十二指肠乳头部病变进行鉴别诊断。Objective To investigate the application value of quantitative Magnetic Resonance Imaging(QMRI)in differential diagnosis of duodenal papilla mucositis,adenoma,and adenocarcinoma.Methods A retrospective analysis was conducted on 52 cases of duodenal papilla mucositis,adenoma,or adenocarcinoma with pathologically proven diagnoses.Three indices were measured:the maximal diameter of the major duodenal papilla,the maximal diameter of the common bile duct,and the ratio of the maximal diameter of the duodenal papilla lesion to the maximal diameter of the common bile duct.Statistical analysis was used to compare these indices among the three groups,and Youden's index was applied to calculate the specificity and sensitivity for groups with significant differences.Results There was no significant difference in the maximal diameter of the duodenal lesion among the three groups(P>0.05).However,significant differences were found in the maximal diameter of the common bile duct and the ratio of the maximal diameter of the duodenal papilla lesion to the maximal diameter of the common bile duct between the adenocarcinoma group and the adenoma group(P<0.05),and between the adenocarcinoma group and the mucositis group(P<0.05).There was no significant difference between the adenoma group and the mucositis group(P>0.05).The diagnostic threshold value for the maximal diameter of the common bile duct was 1.65 cm,with a sensitivity of 0.962 and specificity of 0.731.The diagnostic accuracy was 91.6%.The diagnostic threshold value for the ratio of the maximal diameter of the duodenal papilla lesion to the maximal diameter of the common bile duct was 0.976,with a sensitivity of 0.731 and specificity of 0.769,and the diagnostic accuracy was 81.5%.Conclusion The quantitative indices of the maximal diameter of the common bile duct and the ratio of the maximal diameter of the duodenal papilla lesion to the maximal diameter of the common bile duct can be used to differentiate duodenal papilla adenocarcinoma from mucositis or adenoma.

关 键 词：磁共振成像 十二指肠乳头 腺癌 腺瘤 炎症 胆总管 管径 

分 类 号：R445.2[医药卫生—影像医学与核医学]