磁共振弥散加权成像在急性单纯胰周坏死性胰腺炎的影像诊断价值

Diagnostic value of MRI diffusion weighted imaging(DWI)in peripancreatic necrosis alone acute pancreatitis

目的探讨弥散加权功能成像(diffusion weighted imaging,DWI)序列联合MRI常规序列(T1WI、T2WI和抑脂T2WI)检查在急性单纯胰周坏死性胰腺炎诊断价值。方法选取我院确诊胰腺炎病例134例,63例急性单纯胰周坏死性胰腺炎作为病例组,71例急性间质水肿型胰腺炎作为对照组,所有患者均进行MRI常规序列和DWI序列检查,测得b值=600 s/mm^(2),DWI序列图像在急性单纯胰周坏死性胰腺炎病变内坏死组织的表观弥散系数(apparent diffusion coefficient,ADC)值,计算MRI常规序列、DWI序列联合MRI常规序列两种检查方法的灵敏度、特异性、准确度的差异,绘制DWI联合MRI常规序列的ROC曲线,评价两种检查对急性单纯胰周坏死性胰腺炎的影像诊断价值。结果DWI序列联合MRI常规序列图像显示胰周坏死组织的范围、形态、大小优于MRI常规序列,ADC值1.57~2.13×10^(-3) mm^(2)/s。MRI常规序列与DWI序列联合MRI常规序列检查技术结果比较,灵敏度、特异度、准确度均高于MRI常规序列(93.68%vs 76.94%,92.59%vs 77.98%,93.35%vs 77.39%),差异有统计学意义(P<0.05),ROC曲线下面积分别为0.831,0.975。结论DWI序列联合MRI常规序列(T1WI、T2WI和抑脂T2WI)检查能够早期、明显提高急性单纯胰周坏死性胰腺炎的检出率,DWI可作为急性单纯胰周坏死性胰腺炎MRI常规序列检查的补充序列。

Objective To explore the diagnostic value of diffusion weighted imaging(DWI)sequence combined with conventional MRI sequence(T1WI,T2WI and fat saturation T2WI)in the imaging performance of acute simple peripancreatic necrotizing pancreatitis.Methods A total of 134 confirmed cases of pancreatitis were collected.63 cases of acute simple peripancreatic necrotizing pancreatitis were used as the case group,and 71 cases of acute interstitial edema pancreatitis were used as the control group.All patients underwent routine MRI sequences and DWI sequence examination and the measured b value=600 s/mm^(2).The apparent diffusion coefficient(ADC)values in DWI sequence image of necrotic tissue in the acute simple peripancreatic necrotizing pancreatitis were presented.The differences in sensitivity,specificity and accuracy of MRI routine sequence and DWI combined with conventional MRI sequence were calculated.ROC curves were presented to evaluate the diagnostic value of the two examination methods for acute simple peripancreatic necrotizing pancreatitis.Results The DWI sequence combined with the conventional MRI sequence images showed that the range,morphology,and size of the peripancreatic necrosis tissue were better than those of the MRI conventional sequence,and the ADC value was 1.57~2.13×10^(-3) mm^(2)/s.Compared the results of inspection techniques with the conventional MRI sequence and DWI sequence combined with the MRI conventional sequence,the sensitivity,specificity and accuracy were all higher than those of the MRI conventional sequence(93.68%vs 76.94%,92.59%vs 77.98%,93.35%vs 77.39%).The difference was statistically significant(P<0.05);the area under the ROC curve was 0.831,0.975.Conclusion DWI sequence combined with MRI routine sequence examination can early and significantly improve the detection rate of acute simple peripancreatic necrotizing pancreatitis and can be used as a supplementary sequence for MRI routine sequence examination of acute simple peripancreatic necrotizing pancreatitis.