多种MRI技术联合应用鉴别诊断胰腺癌与慢性胰腺炎

目的　评价联合应用多种MRI技术在鉴别诊断胰腺癌和慢性胰腺炎中的价值。方法　回顾分析 47例胰腺癌与 2 8例慢性胰腺炎的MRI表现。MRI技术包括 :平扫FSFLASHT1WI和TSET2 WI、MR胆胰管成像 (MRCP)及多时相动态增强扫描。测量肿块与正常胰腺信号值 ,计算对比噪声比 (CNR)。结果　平扫FSFLASHT1WI和TSET2 WI对胰头癌的敏感率为 5 9.4% ,对胰体癌为 86.7% ,对慢性胰腺炎为 78.6%。MRCP对胰头癌的敏感率为 90 .6% ,对胰体癌为 6.67% ,对慢性胰腺炎为 82 .1%。多时相动态增强扫描对胰头癌的敏感率为 78.1% ,对胰体癌为 93 .3 % ,对慢性胰腺炎为85 .7%。联合应用多种MRI技术对胰头癌的敏感率为 96.9% ,对胰体癌为 93 .3 % ,对慢性胰腺炎为 92 .9% (P <0 .0 1)。结论　多种MRI技术联合运用 ,是一项对胰腺癌和慢性胰腺炎进行鉴别诊断的准确有效的方法

Differential Diagnosis between Pancreatic Cancer and Chronic Pancreatitis by Combined Application of Various MRI Techniques

Objective To evaluate the value of combined application of various MRI techniques in differential diagnosis between pancreatic cancer and chronic pancreatitis.Methods MRI findings of pancreatic cancer in 47 cases and chronic pancreatitis in 28 cases were analyzed retrospectively.The MRI techniques included:unenhanced FS FLASH T 1WI,TSE T 2WI,MR cholangiopancreatography (MRCP) and multiphase dynamic enhanced FS FLASH T 1WI.Signal intensities of mass and normal pancreas were measured for calculating the CNR.Results The sensitivity of unenhanced FS T 1WI and T 2WI was 59.4% for cancer of the pancreatic head, 86.7% for cancer of the pancreatic body and 78.6% for chronic pancreatitis. The sensitivity of MRCP was 90.6% for cancer of the pancreatic head,6.67% for cancer of the pancreatic body and 82.1% for chronic pancreatitis. The sensitivity of multiphase dynamic enhanced FS T 1WI was 78.1% for cancer of the pancreatic head,93.3% for cancer of the pancreatic body and 85.7% for chronic pancreatitis. The sensitivity of combined MRI techniques was 96.9% for cancer of the pancreatic head,93.3% for cancer of the pancreatic body and 92.9% for chronic pancreatitis( P < 0.01 ).Conclusion Combined application of various MRI techniques is an accurate and efficacious method in differential diagnosis between pancreatic cancer and chronic pancreatitis.