扩散加权成像在胰腺癌诊断中的价值初探

The Primary Study of the Value of Diffusion weighted Imaging in the Diagnosis of Pancreatic Carcinoma

目的探讨MR扩散加权成像(DWI)在胰腺癌诊断中的价值。资料与方法健康自愿者20名,经手术病理和随访证实的胰腺癌患者21例、慢性胰腺炎患者12例,分别行常规MRI和DWI检查。应用自旋回波-回波平面成像(SE-EPI)并采用采集空间敏感性编码技术(ASSET),取b=0和600s/mm2获得DWI图像。分别测量感兴趣区(ROI)的表观扩散系数(ADC)值,行配对t检验。结果健康自愿者胰腺DWI呈中等信号,胰头、胰体尾部ADC值分别为(1.535±0.247)×10-3mm2/s、(1.643±0.375)×10-3mm2/s。21例胰腺癌肿瘤区DWI呈均匀或稍不均匀高信号,ADC值为(1.192±0.117)×10-3mm2/s。健康自愿者胰头与胰体尾部ADC值差异无统计学意义(P>0.05),胰头及胰颈部肿瘤患者胰体尾部ADC值与健康自愿者间差异有统计学意义(P<0.001),胰腺肿瘤ADC值与胰头及体尾部之间差异有统计学意义(P<0.001)。慢性胰腺炎DWI呈不均匀等或稍高信号,ADC值为(1.437±0.385)×10-3mm2/s,与胰腺癌间差异有统计学意义(P<0.05)。结论DWI可以清楚显示肿瘤病灶及范围,ADC值的测定在一定程度上有助于胰腺癌的诊断。

Objective To evaluate the value of MR diffusion weighted imaging （DWI） in the diagnosis of pancreatic carcinoma. Materials and Methods 20 healthy volunteers, 21 patients with pancreatic carcinoma and 12 patients with chronic pancreatitis confirmed by pathology were performed with MR scan including the routine scan and DWI. The SE-EPI sequence and ASSET technique and the parameter h = 0 and 600 s/mm^2 were used to acquire the images, the ADC values in the region of interest was measured. The statistics method was paired-samples t test. Results DW images showed isointensity signals in pancreas of the healthy volunteers, the ADC values in the head and tail of pancreas were （ 1. 535 ±0.247 ） × 10^-3 mm^2/s and （1. 643 ±0. 375 ） × 10^-3mm^2/s, respectively. All of the 21 patients with pancreatic carcinoma DW images showed homogenous and slight inhomogenous hypefintensity signals, the ADC values were （1. 192 ±0.117 ） × 10^-3mm^2/s. The ADC values of the head and tail of the pancreas in healthy volunteers had no significant difference （P 〉 0.05 ）, there was significant difference in ADC value between the head and/or neck of pancreatic carcinoma and that of the healthy volunteer（ P 〈 0.001 ）. The difference in ADC values between the tumor region and the non-tumor region was sig- nificant too （ P 〈 0. 001 ）. The DWI of chronic pancreatitis showed inhomogenous isointensity or slight hyperintensity sig- nal, the ADC value was （1.437 ±0.385）× 10^-3mm^2/s, and the difference in ADC values between chronic pancreatitis and the pancreatic carcinoma was significant （ P 〈 0.05 ）. Conclusion DWI can depict pancreatic carcinoma clearly, the measurement of ADC values is helpful to diagnose pancreatic carcinoma at some extent.