MR弹性成像评价梗阻型慢性胰腺炎

MR elastography for evaluation of obstructive chronic pancreatitis

目的探讨3.0T MR弹性成像(MRE)诊断梗阻型慢性胰腺炎的价值。方法对32例疑诊梗阻型慢性胰腺炎且接受胰十二指肠切除术患者(病变组)及32名健康志愿者(正常对照组)行MRE检查,测量胰腺弹性值。评价2名医师间及重复测量胰腺弹性值的一致性;比较两组胰腺弹性值,绘制ROC曲线,评价以胰腺弹性值鉴别梗阻型慢性胰腺炎的诊断效能。结果 2名评估者间及重复测量胰腺弹性值一致性好(ICC均>0.9);正常对照组及病变组胰腺体部弹性值分别为(1.21±0.11)kPa、(1.51±0.24)kPa,差异有统计学意义(t=-6.077,P<0.001);MRE弹性值诊断有无、轻度与中重度、轻中度与重度慢性炎症的AUC分别为0.900、0.941和0.960(P均<0.001)。结论 MRE可测量胰腺弹性值,有助于临床无创性客观评估慢性胰腺炎的严重程度。

Objective To explore the value of 3.0T MR elastography （MRE） in diagnosis of obstructive chronic pancreatitis. Methods Totally 32 patients （lesion group） with suspected obstructive chronic pancreatitis who underwent pancreaticoduodenectomy and 32 volunteers （normal control group） were enrolled. MRE was performed, and pancreatic stiffness value was measured. The consistency between two observers and the repeatability of the same observer were evaluated. The difference of pancreatic stiffness value was compared between the two groups. The efficacy of pancreatic stiffness value in diagnosis of obstructive chronic pancreatitis was analyzed with ROC curve. Results The consistency between two observers and the repeatability of the same observer were excellent （all ICC〉0.9）. The pancreatic stiffness value of normal control group and lesion group was （1.21±0.11） kPa and （1.51±0.24） kPa, respectively （t=-6.077, P〈0.001）. The area under ROC curve of pancreatic stiffness value in diagnosis of chronic pancreatitis, mild and moderate to severe, mild to moderate and severe was 0.900, 0.941 and 0.960, respectively （all P〈0.001）. Conclusion MRE can objectively measure pancreatic stiffness and noninvasively assess the severity of chronic pancreatitis.