DWI对小胰腺癌(1A期)和小肿块型局灶性胰腺炎的鉴别诊断价值

Value of DWI in the differentiation diagnosis between small pancreatic carcinoma(stage 1A)and small mass-forming focal pancreatitis

目的:探讨扩散加权成像(DWI)对小胰腺癌(1A期)和小肿块型局灶性胰腺炎的鉴别诊断价值。方法:采用3.0T磁共振对21例胰腺小肿块病灶患者(胰腺癌13例,胰腺炎8例)以及10例健康志愿者(对照组)行上腹部常规MRI扫描、三维容积插值屏气检查(3D VIBE)及DWI扫描,DWI基于SE-EPI序列,b值为50,800s/mm^2。比较三组的表观扩散系数(ADC)值和胰腺癌、胰腺炎标准化ADC(病灶ADC值/周围胰腺ADC值)。结果:ADC值由高到低依次为正常胰腺、小肿块型局灶性胰腺炎和小胰腺癌。不同组织的ADC值的差异有统计学意义(F=18.950,P<0.001);胰腺炎、胰腺癌及正常胰腺的ADC值之间差异有统计学意义(P均<0.05)。小肿块型局灶性胰腺炎和小胰腺癌的标准ADC值的差异有统计学意义(P=0.023)。结论:DWI序列有利于小胰腺癌(1A期)的早期发现,ADC值和标准ADC值均有助于鉴别小胰腺癌(1A期)和小肿块型局灶性胰腺炎。

Objective:To investigate the value of diffusion-weighted imaging(DWI)in the differential diagnosis between stage 1A small pancreatic carcinoma(SPC)and small mass-forming focal pancreatitis(SFP).Methods:21 patients with small pancreatic lesion including 13 cases of SPC and 8 cases of SFP,as well as 10 cases of healthy volunteers were enrolled.All of them underwent conventional abdomen MR scanning,three-dimensional volume interpolated breath-hold examination(3D VIBE)and DWI.DWI was based on SE-EPT sequence and b values were taken as 50s/mm 2 and 800s/mm 2.Apparent diffusion coefficient(ADC)value in pancreatic parenchyma of three different groups and normalized ADC(ADC value of mass/ADC value of adjacent parenchyma)between pancreatic carcinoma and pancreatitis were compared and statistically analyzed.Results:ADC value was the highest in the control group,which was followed by SFP and SPC,with significant difference(F=18.950,P<0.001).There were significant differences in ADC values among SFP,SPC and normal pancreas(all P<0.05).Significant difference was existed in the normalized ADC between SPC and SFP(P=0.023).Conclusion:DWI imaging is useful for the early detection of stage 1A SPC;ADC value and normalized ADC value are useful for the differential diagnosis of stage 1A SPC from SFP.