3.0T MR动态增强技术对胰腺肿瘤非病变区域的半定量分析研究

Accessing the non-lesion area of pancreatic carcinomas for semi-quantitative perfusion characteristics by dynamic contrast-enhanced MR imaging at 3.0T

目的对正常胰腺、胰腺癌及胰腺良性肿瘤患者的3.0T MR快速三维动态增强扫描序列进行半定量分析,为临床提供胰腺肿瘤非病变区域的灌注特点及判断潜在病变的半定量指标。方法对40例非胰腺疾病患者(对照组)、43例经病理证实的胰腺癌患者(胰腺癌组)、26例胰腺良性肿瘤患者(胰腺良性肿瘤组)行全胰腺T1权重LA-VA 9期动态增强扫描,将所得数据传至ADW 4.2工作站处理,分别测量对照组胰腺的头、体、尾的30s强化率(SER30)、90s强化率(SER90)、达峰时间(TTP)、正增强积分(PEI)、最大强化斜率(MSI),胰腺癌组及胰腺良性肿瘤组的非病变区域的SER30、SER90、TTP,对所得数据进行统计学分析。结果对照组胰腺头、体、尾的SER30、SER90、PEI、TTP及MSI差异无统计学意义(P>0.05)。胰腺良性肿瘤组非病变区域与对照组任意区域的各项参数差异均无统计学意义(P>0.05);胰腺癌组非病变区与对照组任意区域及胰腺良性肿瘤组非病变区的SER90及TTP均有显著性差异(P<0.05)。结论正常胰腺的不同部位间无灌注差异;胰腺癌的非病变区域存在潜在病变浸润。

Objective To analyze the perfusion features of non-lesion area in pancreatic carcinoma （PC） and pancreat- ic benign tumors by semi-quantitative 3D dynamic contrast-enhanced （DCE） MRI at 3.0T. Methods 40 volunteers with normal pancreas, 43 patients with pathologically verified PC, and 26 patients with pathologically verified pancreatic benign tumors, underwent DCE-MRI on a 3.0T MR system. After bolus injection of 20 ml Gd-DTPA for 15 seconds, breath-hold 3D T1 weighted LAVA sequence was scanned. The perfusion parameters of the head, body and tail of normal pancreas, together with non-lesion area of PC and pancreatic benign tumors were measured and statistically analyzed, including signal enhance-ment ratio at 30 seconds after injection （SER30）, signal enhancement ratio at 90 seconds after injection （ SERgo ） and time to peak （TFP）. Results There was no significant perfusion difference in all perfusion parameters among head, body or tail of normal pancreas （P 〉 0. 05）. The difference of all perfusion parameters between normal pancreas and the non-lesion area of pancreatic benign tumors was also not significant （P 〉 0. 05）. Although the SER30 had no difference between the non-lesion area of PC and normal pancreas, the SER9o and TFP of the non-lesion area of PC were higher than the non-lesion of pancreat- ic benign tumors＇ （P 〈 0. 05）. Conclusion Normal pancreas does not have regional perfusion difference. The perfusion va- riance found in non-lesion area of pancreatic cancer could prompt a potential cancer invasion.