3.0TMRI对胰腺导管腺癌的诊断价值及与病理对照

3.0T MRI and Pathologic Features of Pancreatic Ductal Adenocarcinoma

目的探讨胰腺导管腺癌(Pancreatic ductal adenocarcinoma,PDAC)的3.0TMRI表现及其病理基础,提高对该病影像表现的认识。资料与方法回顾性分析14例经手术病理证实的PDAC的3.0TMRI表现,并与病理作对照分析。结果 14例PDAC均单发。胰头9例,胰体3例,胰尾2例。直径3.8cm—6.3cm,平均4.9cm。病灶呈地图形9例,类圆形5例。实性为主6例,囊性为主5例,囊实性相仿3例。平扫,T1WI上肿瘤实性成分为低信号8例,等信号6例;T2WI脂肪抑制肿瘤实性部分为稍高信号7例,等信号7例。增强MRI扫描,癌肿呈乏血供,在早期轻微强化,在实质期肿瘤逐步增强,延迟扫描,肿瘤表现为相对低信号或等信号,最大强化程度不超过正常胰腺组织。镜下见异型增生肿瘤细胞,有时是不完整的管状或腺体样结构被丰富的纤维间质分隔。结论 3.0TMRI能较好地显示PDAC的整体结构与血供特征,有助于正确诊断。

Objective To investigate 3.0T magnetic resonance imaging （MRI） and pathologic features of pancreatic ductal adenocarcinoma （PDAC） in order to improve the knowledge of this disease. Materials and Methods The MR1 findings in 14 cases with PDAC proved by surgery and pathology were retrospectively analyzed and the imaging findings were correlated with pathology. Results The performance of MRI reveals that all of the pancreatic dnctal adenocarcinoma were manifested single mass. 9 masses were located in the pancreatic head, 3 in the pancreatic body and 2 in the tail. The diameters are 3.8cm-6. 3cm, the median diameter of tumors was 4.9cm, 9 lesions had an irregular contour and 5 showed ellipsoid contour. 6 masses were mainly solid in component, 5 were cystic and 3 were cystic-solid. Solid portions of 8 masses showed hyposignal, 6 isosignal on T1- weighted imaging. Fat-saturated T2-weighted imaging showed that 7 of them were slightly hypersignal, 7 isosignal. PDAC was lack of blood supply. After dynamic MR imaging, tumors were slightly enhanced in the arterial phase; and enhance gradually during the pancreatic phase and in delayed phase the signal intensity were relative isointensity.The degree of the greatest enhanced form will not surpass that of normal pancreatic tissue. Tumors were hypoperfusion. Pathology showed that acinar or cord-like arrangement of tumor cells separated by abundant fibrovascular septa. Conclusion 3.0T magnetic resonance imaging （MRI） could detect the internal structure and blood supply of PDAC, so it is of significant value in diagnosing.