表观扩散系数在急性间质水肿性胰腺炎与急性坏死性胰腺炎中的价值

The Value of MRI Apparent Diffusion Coefficient in Interstitial Edema Pancreatitis and Acute Necrotizing Pancreatitis

目的探讨表观扩散系数在急性间质水肿性胰腺炎(Interstitial edema pancreatitis,IEP)与急性坏死性胰腺炎(acute necrotizing pancreatitis,ANP)中的鉴别诊断价值.方法回顾性分析2017年1~7月MRI诊断为ANP患者24例与IEP患者53例,所有患者均行常规MRI及功能成像DWI(b值为0、800 s/mm2)扫描,结合常规MRI影像学表现,分别测量ANP水肿区、出血区、坏死区ADC值以及IEP的ADC值.使用统计学方法对比分析ANP出血区、坏死区与水肿区的ADC值以及IEP ADC值.结果纳入IEP的53例患者,其ADC值为(1.094±0.170)×10-3 mm2/s,ANP的24例患者,其水肿区ADC值为(1.099±0.127)×10-3 mm2/s,伴有出血7例,出血区ADC值为(0.584±0.061)×10-3 mm2/s,伴有坏死13例,坏死区ADC值为(2.084±0.323)×10-3mm2/s,同时伴有出血及坏死患者4例.IEP及ANP水肿区ADC值差异无统计学意义(P=0.884),IEP的ADC值与ANP出血区ADC值、坏死区ADC值两两比较差异有统计学意义(P<0.001).结论 IEP与ANP水肿区ADC值无明显差异性,ANP出血区ADC值明显低于其水肿区及IEP ADC值,坏死区ADC值明显高于水肿区及出血区,ADC值对鉴别IEP及ANP有重要价值.

Objective To investigate the differential diagnostic value of the Apparent Diffusion Coefficient in Interstitial Edema Pancreatitis（IEP） and Acute Necrotizing Pancreatitis（ANP）. Me thods Twenty-four ANP patients and 53 IEP patients received routine MRI and functional imaging DWI（b value is 0, 800 s/mm^2） scanning were retrospectively analyzed. We measured the ADC values of ANP edema, hemorrhage, necrosis areas and the ADC values of the IEP between January 2017 and July 2017. Statistical methods were used to compare and analyze the ADC values of ANP edema, hemorrhage, necrosis areas and the ADC values of the IEP. Re s ults The ADC values of the IEP were（1.094±0.170） ×10^-3 mm^2/s, and the values of ANP edema, hemorrhage, necrosis areas were（1.099±0.127） ×10^-3 mm^2/s,（0.584±0.061） ×10^-3 mm^2/s,（2.084±0.323） ×10^-3 mm^2/s.There was no statistically significant difference in ADC values in edema area between IEP and ANP（P = 0.884）.Single factor analysis of variance and multiple comparison was used to identify the ADC values of IEP and the values of ANP edema, hemorrhage,and necrosis areas. The results were statistically significant（P 0.001）. Conclus ion The ADC values of IEP and ANP edema zone have no obvious difference. The ADC values of ANP hemorrhage area are significantly lower than those of edema area and IEP. The ADC values of ANP necrotic area are significantly higher than those of edema and hemorrhage area. ADC values have important value in identifying IEP and ANP.