MRI对自身免疫性胰腺炎诊断与鉴别诊断价值.docVIP

MRI对自身免疫性胰腺炎诊断与鉴别诊断价值 　　[摘要] 目的 探讨MRI对自身免疫性胰腺炎的诊断与鉴别诊断价值。 方法 选择2010年2月～2014年4月我院收治的16例自身免疫性胰腺炎患者为AIP组，另选择同期确诊胰腺癌患者15例和体检健康者15例作为PC组和正常对照组，比较各组MRI学征象，并对比AIP组MRI和CT征象。 结果 自身免疫性胰腺炎以弥漫性肿大为主，抑脂T1WI信号强度降低，抑脂T2WI信号强度升高，动脉期呈“雪花状”不均匀低强化，延迟强化，环绕假包膜并伴不同程度胆管和胰管改变。MRI与CT的征象在平扫信号分布、延迟强化、胰管狭窄、假包膜的判断上有显著性差异，MRI诊断AIP优于CT（P0.05）。AIP与PC的MRI征象在范围、平扫信号分布、动脉期强化、胰管改变、假包膜的MRI征象上差异有统计学意义（P0.05），动脉期 “雪花样”不均匀低强化、假包膜是AIP特征。AIP组、PC组和正常对照组在动态增强各期感兴趣区信号强度比值差异有统计学意义（P0.05）。AIP组ADC值最低，AIP、PC的鉴别ADC值为（1.139×10-3）mm2/s，ROC曲线下面积为0.873，灵敏度和特异度分别为83.12%和79.28%。结论 MRI平扫、动态增强、MRCP、DWI多序列联合诊断AIP较CT有明显优势，有助于提高诊断和鉴别诊断准确性。 　　[关键词] 自身免疫性胰腺炎；磁共振成像；胰腺肿瘤；诊断 　　[中图分类号] R816.5 [文献标识码] B [文章编号] 1673-9701（2015）23-0118-04 　　Diagnosis and differential diagnosis value of MRI for autoimmune pancreatitis 　　PAN Hong1 CEN Feng2 　　1.Department of Radiology， Haining Peoples Hospital in Zhejiang Province， Haining 314400， China； 2.Department of General Surgery， Huzhou Central Hospital in Zhejiang Provicne， Huzhou 313000， China 　　[Abstract] Objective To investigate the diagnosis and differential diagnosis value of MRI for autoimmune pancreatitis. Methods Sixteen patients with autoimmune pancreatitis treated in our hospital from February 2010 to April 2014 were assigned to the AIP group， and 15 patients diagnosed with pancreatic cancer and 15 healthy people in the corresponding period were assigned to the PC group and the normal control group. MRI signs of each group were compared and MRI and CT signs of the AIP group were compared. Results Autoimmune pancreatitis mainly manifested as diffuse enlargement， reduced fat-suppressed T1WI signal， elevated fat-suppressed T2WI signal，“snowflake-like” uneven low enhancement in arterial phase， delayed enhancement， surrounding pseudocapsule and varying degrees of bile duct and pancreatic duct changes. MRI and CT signs were significantly different in the plain scan signal distribution， delayed enhancement， pancreatic duct stenosis and diagnosis of pseudocapsule， and MRI was better than