慢性胰腺炎磁共振诊断

Magnetic resonance diagnosis of chronic pancreatitis

目的探讨磁共振(MR)多种成像技术对慢性胰腺炎诊断的准确性及其临床应用价值。方法选择25例经手术病理、临床追踪和其他影像学方法证实的慢性胰腺炎MRI进行回顾性分析,其表现包括胰腺形态和体积改变、信号特征、动态增强扫描和MRCP所见。检查方法包括平扫冠状位T2WI,轴位T1WI,轴位T2WI,轴位T1WI FS(脂肪抑制)序列,磁共振胰胆管水成像(MRCP),动态增强前后的T1WI FS序列。结果胰腺体积弥漫性增大、T1WIFS病变区信号减低、动态增强扫描同步强化及串珠状扩张胰管穿透病变区是慢性胰腺炎的典型表现。结论MRI能更早发现慢性胰腺炎,显示胰管的改变和假性囊肿,对慢性胰腺炎诊断具有重要价值。

Objective To evaluate the accuracy of MRI diagnosis and the clinical value of multi-MR imaging techniques. Methods Clinical, pathologic and MRI findings were retrospectively reviewed in 25 cases with chronic pancreatitis. The MRI manifestation included pancreatic morphology and volume change, signal feature, dynamic contrast-enhanced MRI and MRCP. The MRI techniques included： both before and after Gd-DTPA enhancement FS FLASH T1WI, FLASH TIWI, HASTE T2WI and MRCP. Results The characteristic signs in diagnosis of chronic pancreatitis were as follows： diffuse enlargement of the body;hypointense on T1WI FS; dynamic contrast-enhanced MRI, lesion and normal area always enhanced at the same time; pancreatic duct dilated like a string of beads which penetrated into the lesion shown by MRCP. Conclusion MRI can detect chronic pancreatitis earlier than CT, and it can display pancreatic duct and pseudo-cysts so is of great value in the diagnoses of chronic pancreatitis.