慢性胰腺炎的MRI评价及功能评估

MRI Assessment and Functional Evaluation of Chronic Pancreatitis

目的探讨慢性胰腺炎的磁共振成像(MRI)评价及功能评估。方法复习关于慢性胰腺炎的MRI评价及外分泌功能评估的文献。结果 MRI能发现慢性胰腺炎中胰腺实质的早期改变(包括胰腺大小、实质信号和强化模式的改变),磁共振胰胆管成像(MRCP)能发现胰腺导管系统的改变,促胰液素刺激MRCP进一步提高了对胰管及其分支的显示率,且可无创地评估胰腺的外分泌功能,同时结合了形态学和功能学评估。促胰液素刺激弥散加权成像也可作为另一种提供胰腺外分泌功能信息的无创检查手段。结论常规MRI和(或)促胰液素刺激MRI可作为慢性胰腺炎(尤其是早期慢性胰腺炎)评估方法,同时进行形态学和功能学评估,但仍需进一步的研究验证这些方法的诊断准确性。

Objective To investigate the magnetic resonance imaging （MRI） assessment and functional evaluation of chronic pancreatitis （CP）. Methods Literatures about MR/assessment of CP （especially the evaluation of pancreatic exocrine function with MRI） were reviewed. Results Some early parenchymal changes （pancreatic size, signal intensity of pancreas, and enhancement pattern） in the CP could be visualized by MR/; ductal changes could be visualized by MR cholangiopancreatography （MRCP） ; and secretin-stimulated MRCP （combination of both morphologic and functional evaluation） not only improved the visualization of pancreatic duct and side branches, but also allowed evaluation of the pancreatic exocrine function noninvasively. Secretin-stimulated diffusion weighted imaging also could be used as a noninvasive method to assess pancreatic exocrine function. Conclusions Conventional MRI and （or） secretin-stimulated MR/can become valuable means in CP （especially early-stage CP）, with furnishing morphologic and functional information simultaneously. However, further research is needed to verify the diagnostic accuracy of these modalities.