胰腺癌MRI各征象的诊断价值

目的观察磁共振成像(MRI)中胰腺癌各征象及其组合对胰腺癌诊断的价值。方法因胰腺及其周围疾病手术患者80例,胰腺癌及非胰腺癌各40例。均在术前1个月内进行全面的MR检查。以选定MRI征象或其组合为参考标准,诊断为胰腺癌。结果与手术及病理检查报告对比,进行统计分析,画出ROC曲线。结果应用动态对比增强诊断胰腺癌效果较好,40例胰腺癌发现36例,在40例其他疾病中有6例被错误地归类至胰腺癌。其敏感性、特异性和正确性分别为90%、85%和87.5%。应用磁共振胰胆管造影(MRCP)检查,以胰管非穿透性扩张为指标,特异性95%,敏感性52.5%。结论动态对比增强检查在应用MRI诊断胰腺癌时非常重要,在动态对比增强的MRI图像中发现病灶呈轻度或无强化是诊断胰腺癌的较好指标。MRCP对胰头癌诊断很有必要,如发现胰腺改变并有胰管非穿透性扩张,则诊断基本可以确立。

Diagnostic Value of MRI Signs in Pancreatic Cancer

Objective To investigate the value of various signs and their combination of MRI in the diagnosis of pancreatic cancer.Method Eighty suspected patients of pancreatic tumors who accepted the operation because of pancreas and its related diseaese,including 40 cases of pancreatic cancer and 40 cases of non-panereatic cancer,underwent MR imaging(unenhanced and contrast material-enhanced MR),MR cholangiopancreatography(MRCP) in a month before the operation.Pancreatic cancer was diagnosed by the selected signs MR imaging and the combination of the signs.The results were compared with the surgery and biopsy report and analyzed statisticaly.The ROC curve was drawn out.Results Diagnosing pancreatic cancer through contrast material-enhanced MR was appropriate.Among histologically proved malignant tumors,MR imaging yielded correct diagnosis in 36 of 40 patients,whereas 34 of 40 patients with other diseases were classified correctly.Its sensitivity,specificity and curracy was 90%,85% and 87.5%,respectively.Diagnosing pancreatic cancer by the duct non-penetrating sign at magnetic resonance(MR) cholangiopancreatography(MRCP) has high specificity(95%) and sensitivity(52.5%).Conclusions Contrast-enhanced MR imaging is important for the diagnosis of pancreatic cancer.After administration of Gd-chelate,the tumor appears distinctly hypointense to pancreas in T1WI during the arterial phase of dynamic enhancement,which is a proper indicator for diagnosing pancreatic cancer.MRCP is necessary for distinguishing carcinoma of head of an inflammatory pancreas.If pancreatic mass and non-penetration dilatation of pancreatic duct are detected,the diagnosis of pancreatic cancer can be confirmed.