胰腺癌与慢性胰腺炎的MRI诊断研究.pdf

摘 要 目的 通过胰腺癌与慢性胰腺炎VII 」诊断与鉴别诊断的回顾性研究， 评价MRI对于胰腺癌与慢性胰腺炎诊断的准确性及其临床应用价值。方法 根据被证实的57例胰腺癌，慢性胰腺炎病例的MRI资料，对18个征象进 行观测，统计与分析。检查方法包括平扫TIWI,T2VVI,MRCP，动态增 强前后的脂肪抑制T1WI。结果 二者诊断与鉴别诊断的主要征象是:1)病 变区胰腺局限或弥漫肿大与信号异常;2)有无扩张的胆总管突然性狭窄截 断与胰周大血管包埋、管径增粗、癌栓、腹部淋巴结肿大、肝转移;3)胰 腺囊肿的发生频率、部位，与胰腺轮廓的关系。4)有无扩张胰管，扩张胰 管的形态与贯穿病变区的情况，有无沿胰管走向分布的钙化 (结合CT). 结论 根据前述观点，参考其他征象，密切结合临床、CT检查，MRI诊断 的准确率与CT相仿，但对显示胰腺肿瘤侵犯血管，MRI优于CT，同时由 于MR!无辐射及新的实用技术 (MRCP，动态增强扫描及细胞特异性对比 剂等)的应用，使MRI成为胰腺疾病重要的检查手段，具有较高的临床应 用价值。 关「键词〕 胰腺;肿瘤;胰腺炎;磁共振;评价研究 Abstract carcinom a andchronicpancreatitis MRIdiagnosisofpancreatic Objective ToevaluatetheaccuracyofMRIdiagnosisanditsclinical valuebyretrospectiveresearchMRIdiagnosisanddifferentialdiagnosis betweenpancreaticcarcinomaandchronicpancreatitis.Materialsand MethodsTheMRIfindingsof57caseswith.pancreaticcarcinomaand chronicpancreatitisprovenclinicallyandpathologicallywereanalyzed.The MRItechniquesincluded:unenhancedFLASHTI)VI,unenhancedFSFLASH TIWI,HASTET2WI,MRcholangiopancreatography(MRCP)andmultiphase dynamicenhancedFSFLASHTIWI.ResultsThemainsignsindiagnosis anddifferentialdiagnosisbetweenpancreaticcarcinomaandchronic pancreatitisincluded:1)focalordiffuseenlargementandsignalintensity abnormalityofpancreas;2)dilatedcommonbileductwassuddenlyobstructed, peripancreaticbloodvesselswereinvadedandcancerousthrombuswere revealed,enlargementofabdominallymphnodesandmetastasisintheliver werediscovered;3)presenceandlocationofpancreaticcystandits relationshiptopancreaticcontour;4)calciumdepositinthepancreaticductarea, dilatedpancreaticductwhichpassedthroughthelesionornot(connectedwith CT).ConclusionTheaccuracyofMRIinthediagnosisofpancreaticdiseases issimilartoCT.Butwhentodisplayinvadingofperipancreaticbloodvessels, MRIissuperiortoCT.Andatthesametime,noradiationandtheuseofnew practicalapproachmakeNIRIbecomeanimportantdetectingmeansfor pancre