抑脂技术和动态增强MRI在胰岛素瘤诊断中的价值探讨  

Value of fat suppression and dynamic contrast-enhanced MRI in the diagnosis of insulinoma

作　　者：徐增斌[1] 阮凌翔[1] 彭志毅[1] 张敏鸣[1] 许顺良[1] 章熙道[1] 

机构地区：[1]浙江大学医学院附属第一医院放射科,杭州310003

出　　处：《中华放射学杂志》2003年第12期1101-1104,共4页Chinese Journal of Radiology

摘　　要：目的　探讨抑脂技术和动态增强MRI在胰岛素瘤术前定位诊断中的价值。方法12例手术病理证实的胰岛素瘤患者术前行MR检查 ,扫描序列包括 :横断面SET1WI,快速自旋回波(FSE)T2 WI,加脂肪抑制技术的T1WI和T2 WI(即T1WI +FS和T2 WI+FS) ,快速多层面扰相梯度回波(FMPSPGR)序列作动态增强扫描。结果　在常规T1WI和T2 WI序列仅检出 4例肿瘤 ,表现为T1WI稍低信号和T2 WI稍高信号。在T1WI+FS上 7例呈均匀低信号 ,显示清晰 ;在T2 WI+FS上 6例病灶呈不同程度的高信号。快速动态增强扫描 (FMPSPGR)检出 11例肿瘤 ,在动脉期 7例肿瘤明显强化呈高信号 ,4例轻度强化呈稍高信号 ,1例无明显强化呈等信号 ,胰腺实质期和门脉期 6例仍呈高信号 ,6例呈等信号。与手术后病理结果比较 ,动态增强MRI对胰岛素瘤术前定位诊断准确率为 91.7% (11/12 )。结论　动态增强MRI是胰岛素瘤术前定位诊断敏感而准确的方法。Objective To evaluate the value of fat suppression and dynamic contrast-enhanced MRI in the preoperative localization of insulinoma. Methods Twelve cases with pathologically proven insulinoma were evaluated with MRI. SE T 1WI, FSE T 2WI, T 1WI and T 2WI with fat suppression, dynamic contrast-enhanced FMPSPGR sequences were used in MR scanning. Results On SE T 1WI, the lesions displayed hypointense in 4, isointense in 8 cases. Lesions showed hyperintense in 4, isointense in 8 cases on FSE T 2WI. In contrast, 7 cases appeared as hypointense on T 1WI with fat suppression and 6 cases appeared as hyperintense on T 2WI with fat suppression. With dynamic contrast-enhanced FMPSPGR sequence 11 of 12 insulinomas were detected. In the arterial phase, the lesions presented as hyperintense with different degrees in 11 cases and isointense in 1 case. 6 cases remained hyperintense and 6 cases were isointense in pancreatic parenchymal and portal phase. 4 lesions were identified only in dynamic enhancement images. The diagnostic accuracy of insulinoma by dynamic contrast-enhanced MRI was 91.7% (11/12) as compared with histological study. Conclusion The results indicate that dynamic contrast-enhanced MRI is an sensitive and accurate method for the preoperative localization of insulinoma.

关 键 词：抑脂技术 MRI 胰岛素瘤 诊断 磁共振成像 动态增强扫描 

分 类 号：R736.7[医药卫生—肿瘤] R730.4[医药卫生—临床医学]