3．0T 磁共振扩散加权成像在胰腺癌诊断中的应用价值

摘要

Objective To explore the application value of diffusion - weighted imaging in the diagnosis of pancreatic canc‐er with 3 .0 T MR .Methods The clinical and imaging data of 27 patients with confirmed pancreatic cancer in our hospital from March 2012 to January 2014 were retrospectively analyzed and the imaging characteristics of pancreatic cancer on 3 .0 T MR were summarized in this work .Results The direct signs at T1 WI showed low signal in 22 cases ,isointensity in 2 cases and those at T2 WI showed slightly high signal in 21 cases ,isointensity in 6 cases .At the arterial phase of the en‐hancement scanning ,lesions were shown relatively low signal ,at the portal vein period and balance period ,the center of lesions were shown low signal and irregular margin enhancement with different degree ,while ,at the delayed phase ,the imagings were similar to those at the balance period .There were 16 cases with extrahepatic and intrahepatic bile duct ex‐pansion and 9 cases with distal pancreatic duct expansion with different levels .Average ADC value of normal pancreas was significantly different in comparison to that of the cancer or pericancerous tissues ( P < 0.05) ,but ,average ADC value of the cancer and pericancerous tissue was no significant difference ( P > 0 .05) .Conclusion DWI can clearly display the pancreatic lesions ,especially the small lesions with the diameter of < 2 .0 cm .Combined with the quantitative analysis of ADC value ,DWI can distinguish between tumor and normal pancreatic tissue ,which has an important value for early diag‐nosis of pancreatic cancer and the clinical stages and helps for the early screening and diagnosis of pancreatic cancer .%目的：探讨3．0T 磁共振扩散加权成像（DWI）在胰腺癌诊断中的应用价值。方法分析2012年3月～2014年1月我院确诊的27例胰腺癌患者临床及影像学资料，总结胰腺癌3．0T MR 影像学特点。结果 MR 直接征象 T1 WI呈低信号22例，等信号2例，T2 WI 稍高信号21例，等信号6例；增强扫描动脉期病灶均呈相对低信号，门静脉期、平衡期病灶中心低信号，边缘强化不规则，程度不等，延迟扫描图像与平衡期相似；肝内外胆管扩张者16例，远端胰管不同程度扩张9例。 ADC 平均值正常胰腺组织与胰腺癌、瘤周组织比较均有显著差异（ P ＜0．05），胰腺癌与瘤周组织 ADC 平均值比较无显著差异（ P ＞0．05）。结论 DWI 可清晰显示胰腺癌病灶，对直径＜2．0cm 的小病灶显示较好，结合定量分析ADC 值可区分肿瘤与正常胰腺组织，对胰腺癌早期诊断及临床分期具有重要价值。