MRI与CT检查对急性胰腺炎的比较研究

Comparison of MRI and CT in Diagnosing Acute Pancreatitis

目的分析急性胰腺炎(以下简称AP)病变在MRI各脉冲序列及CT的表现,了解不同MRI序列及CT显示各种AP病变的优势及不足。方法AP住院患者21例,均进行MRCP,轴位T1WI、T2WI、T2WI压脂4种脉冲序列成像及同期CT成像。观察胰腺大小、形态、密度、信号改变,胰周有无渗出及范围,肾前筋膜有无增厚,有无急性液体积聚及假性囊肿。在SPSS11.5软件包上采用χ2检验对观察结果进行统计学分析。结果MRCP原始像和3DMIP由于可多方位成像对胰液的渗出范围,与周围器官的关系均可以做出准确评定;轴位T1WI对组织的水肿、出血较为敏感,估计渗出范围准确;T2WI对急性液体积聚,假性囊肿显示良好;T2WI压脂可判断病变组织是单纯的水肿,还是合并积液。结论本研究提示,MRI与CT对AP具有同等诊断价值,不同MR序列对AP病变的显示具有互补作用。在显示病变性质及对指导临床治疗方面,MRI的作用甚至优于CT。

Objective To prospectively study the ability to visualize and diagnose the abnormal signs in patients with acute pancreatitis （AP） in four MR pulse sequences （MRCP,T1WI,T2WI, T2WISPIR） and CT images, as well as explore the advantages and shortings of above four MR sequences and CT images in demonstrating the lesions. Methods Four different pulse sequences MR images and CT images were obtained in 21 patients with acute panereatitis, who were treated for AP at Beijing Friendship Hospital. Analyzing the visualization of abnormal signs, such as the size ,shape ,density,signal intensity changes of pancreas ,exudation and distribution of AP in peripancreatic space,retroperitoneal space and peritoneal space, whether or not incrassation of renal fascia, fluid collections and/or pseudocyst occurred. Results Source images of MRCP and MIP MRCP could accurately detected the location and area of exudation, axial T1WI was superior to other sequences in showing edema, hemorrhage, extra pancreatic spread of AP, acute fluid collection,psudocyst could be accurately detected on T2WI. T2WI/SPIR could identify simple edema or exudation in edema simultaneously. Conclusion MRCP,T1WI,T2WI,T2WISPIR had similar diagnostic value to CT scan for AP. MRI was superior to CT in showing character of pathological changes of AP and guiding clinical therapy.