高场MRI多序列联合检查对胰腺癌分期的应用价值

Value of MRI with Multi-Sequence in Preoperative Staging of Pancreatic Cancer

目的:探讨MRI多序列联合检查在胰腺癌术前分期的临床应用价值。方法:回顾性分析25例经手术及病理证实的胰腺癌患者的MRI表现,并与手术及病理结果进行对照。所有患者进行T1WI、T2WI、MRCP以及多期动态增强序列检查。结果:I期患者4例,Ⅱ患者12例,III期患者7例,IV期患者2例。胰腺癌Ⅱ期、III期诊断的灵敏性、特异性、准确率、阳性预测值与阴性预测值分别为91.7%与85.7%、92.3%与94.4%、92.0%与92.0%、91.7%与85.7%、92.3%与94.4%。MRI术前分期与术中及病理有较好的一致性(k=0.841),分期准确率为88.0%。结论:MRI、MRCP联合多期动态增强序列检查在胰腺癌的诊断及分期方面具有重要的临床意义。

Purpose： To explore the value of MR/with multi-sequence in the diagnosis of pancreatic cancer. Method： MR/data of 25 patients with pathologically confirmed pancreatic cancers were retrospectively analyzed and compared to the operation and pathological findings. T1WI, T2WI, MRCP and multi-phase dynamic enhancement were performed. Results： Based on MR/images, the tumor was divided into stage Ⅰ （4 cases）, stage Ⅱ （12 cases）, stage Ⅲ（7 cases）, and stage IV （2 cases）. The sensitivity, specificity, positive predictive value and negative predictive value of MR/assessment for preoperative staging of pancreatic cancer were 91.7%, 92.3%, 92.0%, 91.7%, 92.3% for stage Ⅱ , and 85.7%, 94.4%, 92.0%, 85.7%, 94.4% for stage Ⅲ.There was a good consistency between MR/assessment and pathological findings （k value=0.841）. The accuracy rate of MR/assessment for preoperative staging of pancreatic cancer was 88.0%. Conclusion： MR/with MRCP and multi-phase dynamic enhancement has considerable value in preoperative staging of pancreatic cancer.