| 张霆霆,王莉,陆建平,柏梅.MR动态增强鉴别诊断胰腺癌与肿块型胰腺炎[J].中国医学影像技术,2010,26(9):1721~1724 |
| MR动态增强鉴别诊断胰腺癌与肿块型胰腺炎 |
| Dynamic contrast-enhanced MRI in differentiation of pancreatic carcinoma from mass-forming focal pancreatitis |
| 投稿时间：2010-04-14 修订日期：2010-06-23 |
| DOI： |
| 中文关键词: 磁共振成像 诊断显像 胰腺肿瘤 胰腺炎 |
| 英文关键词:Magnetic resonance imaging Diagnostic imaging Pancreatic neoplasms Pancreatitis |
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| 中文摘要: |
| 目的 探讨MR动态增强对胰腺癌(PC)与肿块型胰腺炎(FP)的诊断与鉴别诊断价值。 方法 收集经手术病理或临床证实的PC患者28例、FP患者15例及正常胰腺对照20名。各受检者均接受胰腺MR五期动态增强扫描。采用感兴趣区(ROI)法测量胰腺肿块及其周边胰腺各期信号值,计算胰腺肿块各期强化率,并绘制出肿块区及周边胰腺时间-信号强度曲线(TIC)。根据强化峰值时间将TIC分为五型(依次为注射对比剂后18 s、45 s、75 s、150 s、240 s达到峰值),即Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ型。根据TIC尾部走行趋势,将肿块区的每型进一步分为两个亚型,即a(缓慢下降)型与b(平台趋势)型。 结果 正常胰腺动态增强均呈Ⅰ型强化曲线。Ⅳb及Ⅴ型仅出现在PC中(P=0.036、0.008),Ⅰa及Ⅱa仅出现在FP中(P=0.037、<0.001),肿块周边胰腺的Ⅰ型强化曲线更多见于PC(P=0.027),且动脉期PC的强化率低于FP的强化率(P=0.031)。 结论 MR多期动态增强扫描有助于诊断、鉴别诊断PC与FP。 |
| 英文摘要: |
| Objective To observe the value of multi-phase dynamic contrast enhancement MRI (DCE-MRI) in diagnosis and differential diagnosis of pancreatic carcinoma (PC) and mass-forming focal pancreatitis (FP). Methods All the subjects underwent five phases DCE-MRI were divided into 3 groups, i.e. pancreatic carcinoma (n=28) confirmed by pathology, mass-forming focal pancreatitis (n=15) confirmed by pathology or clinical diagnosis, and normal pancreas (n=20). Signal intensity of ROI was measured at the pancreas on all five phases, and for each, the enhanced rate was calculated. Meanwhile, time-signal intensity curves (TIC) of the mass and the remaining pancreas were obtained in all the groups. Then the patterns of the TICs were classified into 5 types according to the time of a peak (18 s, 45 s, 75 s, 150 s, 240 s after bolus injection of contrast material), namely, type-Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ, respectively. Then according to the profile of the tail of TIC, the type of the masses were classified into two subtypes, subtype-a (slow decline) and subtype-b (plateau). Results All normal pancreases had demonstrated TIC type-Ⅰ. Type-Ⅳb and type-Ⅴ TIC were only recognized in PC (P=0.036, 0.008), while type-Ⅰa and type-Ⅱa only in FP (P=0.037, <0.001). Furthermore, type-Ⅰ TIC in the remaining pancreas was recognized more in PC than FP (P=0.027). Besides, in the arterial phase, enhanced rate in PC was lower than in FP (P=0.031). Conclusion Multi-phases DCE-MRI may help to differentiate PC from mass-forming FP. |
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