MRI DWI在急性水肿型胰腺炎诊断中的价值

MRI DWI diagnosis of acute edematous pancreatitis

目的探讨弥散加权成像(diffusion-weighted imaging,DWI)在急性水肿型胰腺炎诊断中的价值。方法采用Philips公司生产的Intra Achieva 1.5T磁共振成像系统获得MRI图像和b0=0s/mm2,b1=800s/mm2的DWI图像,测量21例急性水肿型胰腺炎及21例正常胰腺的大小径线,T1W、T2W胰头、胰体的信号强度,计算胰腺的表面弥散系数(apparent diffusion coefficient,ADC)值。采用SPSS 11.5软件进行统计学处理。结果 21例中T1W 16例低信号,5例等信号,T2W 12例为高信号,9例等信号,DWI均表现为高信号,6例胰腺周围见少量渗出和液体信号,均无明显坏死改变。与对照组比较,胰腺炎组DWI信号明显增高,ADC值低于对照组(P<0.01),肝脏及脾脏的ADC值二组无明显差异(P>0.05)。胰腺炎组胰头及胰体的径线大于对照组,胰体增大更显著(P<0.01)。结论胰腺DWI上信号增高对于诊断急性水肿型胰腺炎有一定价值,ADC值的减低是急性水肿型胰腺炎的量化指标。

Objective To evaluate the efficacy of DWI in diagnosing acute edematous pancreatitis（AEP）.Methods The abdominal MRI and DWI at 1.5 T（Philips;Intra Achieva） were established.The diffusion coefficient（ADC） was calculated at b0=0s/mm2,b1=800 s/mm2.The pancreas size and signal intensity of 21 AEP patients and the control group（21 normal pancreas cases） were calculated respectively.All statistical analyses were performed using SPSS（statistical package for social sciences） version 11.5 for windows.The ADC values and the size of cases ware reported as the mean ± standard deviation.A P value of less than 0.05 was considered to indicate a statistically significant difference.Results Among 21 AEP patients 16 cases showed low signal intensity,5 cases isointensity in T1WI,and 12 cases high intensity,9 cases isointensity.The DWI of pancreas showed high intensity in all 21 AEP patients.There were statistically significant differences among ADC values for AEP and control group（P 0.05）.the apparent diffusion coefficient（ADC） map in AEP revealed a more reduced ADC value than control group（P 0.01）.The size of pancreas of AEP group was large（P 0.05）.Conclusion DWI can be valuable for the diagnosing acute edematous pancreatitis.The ADC is a quantitative value in evaluate AEP.