在体1.5T氢质子波谱鉴别慢性肿块型胰腺炎与胰腺癌

In vivo proton magnetic resonance spectroscopy on differentiation of chronic mass-forming pancreatitis from pancreatic carcinoma on 1.5T MR

目的探讨正常胰腺、慢性肿块型胰腺炎(CMFP)与胰腺癌(PC)的在体氢质子磁共振波谱(1H-MRS)表现,评价应用在体1H-MRS鉴别CMFP与PC的可行性。方法经手术病理和穿刺活检或随访证实的胰腺病变患者28例,分为CMFP组(n=7)和PC组(n=21);以20名健康志愿者作为正常对照组。应用1.5T磁共振单体素PRESS序列采集胰腺病变患者肿块实质部分和正常对照组的胰腺头部波谱,测量1.80～4.10ppm之间所有物质的峰面积与脂肪(0.90～1.80ppm)峰面积的比值(P[1.80～4.10ppm]/P[0.90～1.80ppm]),并比较三组间该比值的变化。结果在体1H-MRS显示CMFP组脂肪相对含量较PC组显著减少,但CMFP组和PC组仍明显低于正常对照组的脂肪相对含量。CMFP、PC和正常胰腺P[1.80～4.10ppm]/P[0.90～1.80ppm]均值分别为2.52±1.42、0.72±0.70、0.35±0.28,三组间差异有统计学意义(P<0.05)。结论CMFP、PC与正常胰腺间1H-MRS有显著差异;1H-MRS对于鉴别CMFP和PC是一种有效的方法。

Objective To explore the in vivo proton magnetic resonance spectroscopy （^1 H-MRS） features of chronic massforming pancreatitis （CMFP）, pancreatic carcinoma （PC） and normal pancreas, and to evaluate the possibility of discriminating CMFP from PC with ^1 H-MRS in vivo. Methods A total of 28 patients confirmed pathologically or through follow-up were divided into CMFP group （n=7） and PC group （n=21）, and 20 normal volunteers were selected as control group. The spectra were obtained in pancreatic lesions and normal pancreatic head using single-voxel PRESS sequence on 1.5T MR. The ratios of the peak area of all peaks at 1.80-4. 10 ppm to lipid （0. 90-1.80 ppm） （P[1.80-4.10 ppm]/P[0.90- 1.80ppm]） in 3 groups were evaluated and compared. Results In vivo 1 H-MRS showed relative amount of lipid in CMFP group was less than that in PC group, but the relative amount of lipid in CMFP and PC group was significantly less than that in control group. The ratio of P[1.80-4.10 ppm]/P[0.90-1.80 ppm] in CMFP group, PC group and control group was 2.52±1.42, 0.72±0.70, 0.35± 0. 28, respectively （P〈0.05）. Conclusion CMFP, PC and normal pancreas are significantly different on in vivo ^1 H-MRS, which can be a useful method for differential diagnosis between CMFP and PC.