胰头癌的MRI诊断及鉴别诊断

目的：探讨磁共振成像对胰头癌的诊断价值。方法：回顾性分析28例经手术病理及其它方法证实的胰头痛变的MRI表现。扫描序列包括SE序列T1WI、FSE序列T2WI、T1WI FS、T2WI FS、25例行MRCP,12例行增强扫描。结果：26例MRI诊断为胰头癌,23例诊断正确。2例为胰头炎性病变误诊为胰头癌。23例胰头癌T1WI、T2WI肿瘤信号呈多样性,T1WI FS肿瘤组织低于正常胰腺组织,MRCP呈“双管征”,胆总管下端呈截断征象。结论：应用MRI多序列成像结合MRCP、能够对胰头癌进行准确定位,并有较高的定性价值。

MR imaging diagnosis and differential diagnosis of the carcinoma of the pancreatic head

Objective:To evaluate MRI manifestations and diagnostic value in the carcinoma of the pancreatic head.Methods:MR features of 28 cases with pancreatic head lesions confirmed pathologically and clinically were retrospectively analysed.SE sequences with T 1WI and fat saturation,FSE with T 2WI and fat saturation were performed in all 28 cases. Additional MRCP was performed in 25 cases and additional enhanced MRI in 12.Results:carcinoma of the pancreatic head was diagnosed by MRI in 26 cases,of which 23 were correctly made,and 2 of chronic pancreatitis misdiagnosed as carcinoma.Various signals of 23 cases of carcinoma were presented on T 1WI and T 2WI,and hypointensity was shown on T 1WI with fat saturation.MRCP demonstrated typical "double duct sign"and abrupt interruption at distal segment of dilated common bile duct.Conclusion:With the combined application of MR imaging with multiple sequences and MRCP,carcinoma of the pancreatic head can be localized and diagnosed accurately.