多种磁共振检查技术在胰腺癌诊断中的应用价值_临床医学论文.docVIP

多种磁共振检查技术在胰腺癌诊断中的应用价值_临床医学论文 多种磁共振检查技术在胰腺癌诊断中的应用价值_临床医学论文 作者：何伯圣，黄 胜，龚沈初，姜洪标，王天乐 【摘要】 目的:探讨多种MRI检查技术在胰腺癌诊断中的应用价值。方法：经手术病理和临床证实的胰腺癌109例，经常规胰腺扫描序列（FLASH 2d和3d T1WI、倾斜横断面FS-T1WI、TSE-T2WI）、MRCP、Gd-DTPA动态增强扫描对胰腺癌、胰胆管扩张、周围血管侵犯及小胰腺癌诊断价值。结果：常规MRI序列对胰腺癌确诊99例（90.8%）；MRCP可清晰、准确显示胆总管和胰管扩张，胰头癌“双管征”显示66例（97.1%）；动态增强扫描对评价胰腺癌周围血管浸润、肝转移有较高价值。本组小胰腺癌24例（22.0％），其中手术切除21例（87.5％）。结论：联合应用多种MRI检查技术可提高胰腺癌的诊断准确性；直径小于3.0 cm的小胰腺癌无局部浸润和远处转移有利于提高手术切除率。 【关键词】 胰腺癌；磁共振成像术；诊断 [Abstract] Objective：To study the diagnostic value of varied techniques of MRI for pancreatic carcinoma. Methods：MRI findings of pancreatic carcinoma in 109 cases were analyzed retrospectively. All the cases were confirmed by operation, pathology and clinical practice. Conventional pancreatic sequences ( FLASH 2d T1WI, FLASH 3d T1WI, Declivate transection FS-T1WI, TSE-T2WI), MR cholangiopancreatography (MRCP) and dynamic contrast of Gd-DTPA sequences were used to find pancreatic lumps, adjacent infiltrated blood vessels and small pancreatic carcinoma. Results：The diagnostic accuracy of conventional sequences for pancreatic carcinoma was 90.8%(99/109); MRCP demonstrated the dilatation of bile duct and pancreatic duct tree clearly and precisely. The display rate of Double Duct Sign on pancreatic head carcinoma was 97.1% (66/68); There was important value in studing vascular invasion and liver metastasis on dynamic contrast sequences. A small pancreatic carcinoma was defined as a lesion smaller than 3 cm in diameter, without local invasion or distant metastasis. The incidence rate of small pancreatic carcinoma on our study was 22.0%(24/109), and the surgical respectability rate of them was 87.5%(21/24). Conclusion：Combined application of varied MRI techniques is an efficacious method to elevate the diagnosis accuracy of pancreatic carcinoma. The diagnostic standard of small pancreatic carcinoma defined by authors was useful to improve the surgical rate of pancreatic carcinoma. 胰腺癌是恶性程度很高的消化道肿瘤，发现时往往已到中、晚期，失去手术机会，预后较差，5年生存率不足5%[1