中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2014年
4期
294-298
,共5页
边云%王莉%陈超%陆建平%陈士跃%赵冰辉
邊雲%王莉%陳超%陸建平%陳士躍%趙冰輝
변운%왕리%진초%륙건평%진사약%조빙휘
胰腺炎,慢性%磁共振成像%对比研究
胰腺炎,慢性%磁共振成像%對比研究
이선염,만성%자공진성상%대비연구
Pancreatitis,chronic%Magnetic resonance imaging%Comparative study
目的 探讨胰泌素增强MR胰胆管成像(MRCP)联合常规胰腺MRI对慢性胰腺炎(CP)诊断的价值.方法 收集17名健康志愿者和36例CP患者在注射胰泌素前后多期MRCP和冠状面T2 WI、常规胰腺平扫和增强MR资料.观察注射胰泌素前后的胰管变化,胰腺外分泌功能的评估采用十二指肠充盈度分级法,测量平扫时胰腺与同层面左侧腰大肌的信号强度比(SIR)和增强扫描时胰腺实质期和延迟期同层面信号强度比值(A/V)来观察胰腺实质MR特征.将53例受试者按照健康志愿组和CP患者不同剑桥分级进行分组,并按照十二指肠充盈正常和异常进行分组,观察SIR和A/V.采用单因素方差分析比较健康志愿者和CP患者不同剑桥分级各组患者的SIR和A/V值.十二指肠内充盈正常组和异常组SIR和A/V值的比较采用独立样本t检验.剑桥分级、十二指肠充盈度分级与SIR、A/V之间相关性分析采用Spearman秩相关检验.结果 胰泌素注射后所有受试者主胰管和分支胰管均较注射前图像质量提高,17名健康志愿者中均未见分支胰管显示.注射胰泌素11 min后,17名健康志愿者十二指肠充盈均为3级,36例CP患者中十二指肠内充盈3级、2级、1级者分别为23、8和5例.依据剑桥分级,CP轻度、中度和重度患者分别为11、12和13例,健康志愿组、CP轻度组、CP中度组和CP重度组SIR值分别为1.21 ±0.19、1.07 ±0.21、0.98 ±0.21和0.85 ±0.18,A/V值分别为1.15 ±0.11、1.23±0.34、0.97 ±0.16和0.91 ±0.12,差异均有统计学意义(F值分别为8.72和7.72,P值均＜0.01).十二指肠充盈正常组和异常组患者分别为40和13例,SIR分别为1.09 ±0.20和0.88±0.27,A/V分别为1.15 ±0.11和0.94±0.30,差异均有统计学意义(t值分别为3.10和-2.40,P值均＜0.05).剑桥分级、十二指肠充盈度分级与SIR值有相关性,r值分别为0.60和0.41,P值均＜0.01;与A/V也均有相关性,r值分别为0.60和0.52,P值均＜0.01.结论 胰泌素增强MRCP联合胰腺常规MR扫描可以从形态和功能方面诊断CP,为临床诊断提供参考.
目的 探討胰泌素增彊MR胰膽管成像(MRCP)聯閤常規胰腺MRI對慢性胰腺炎(CP)診斷的價值.方法 收集17名健康誌願者和36例CP患者在註射胰泌素前後多期MRCP和冠狀麵T2 WI、常規胰腺平掃和增彊MR資料.觀察註射胰泌素前後的胰管變化,胰腺外分泌功能的評估採用十二指腸充盈度分級法,測量平掃時胰腺與同層麵左側腰大肌的信號彊度比(SIR)和增彊掃描時胰腺實質期和延遲期同層麵信號彊度比值(A/V)來觀察胰腺實質MR特徵.將53例受試者按照健康誌願組和CP患者不同劍橋分級進行分組,併按照十二指腸充盈正常和異常進行分組,觀察SIR和A/V.採用單因素方差分析比較健康誌願者和CP患者不同劍橋分級各組患者的SIR和A/V值.十二指腸內充盈正常組和異常組SIR和A/V值的比較採用獨立樣本t檢驗.劍橋分級、十二指腸充盈度分級與SIR、A/V之間相關性分析採用Spearman秩相關檢驗.結果 胰泌素註射後所有受試者主胰管和分支胰管均較註射前圖像質量提高,17名健康誌願者中均未見分支胰管顯示.註射胰泌素11 min後,17名健康誌願者十二指腸充盈均為3級,36例CP患者中十二指腸內充盈3級、2級、1級者分彆為23、8和5例.依據劍橋分級,CP輕度、中度和重度患者分彆為11、12和13例,健康誌願組、CP輕度組、CP中度組和CP重度組SIR值分彆為1.21 ±0.19、1.07 ±0.21、0.98 ±0.21和0.85 ±0.18,A/V值分彆為1.15 ±0.11、1.23±0.34、0.97 ±0.16和0.91 ±0.12,差異均有統計學意義(F值分彆為8.72和7.72,P值均＜0.01).十二指腸充盈正常組和異常組患者分彆為40和13例,SIR分彆為1.09 ±0.20和0.88±0.27,A/V分彆為1.15 ±0.11和0.94±0.30,差異均有統計學意義(t值分彆為3.10和-2.40,P值均＜0.05).劍橋分級、十二指腸充盈度分級與SIR值有相關性,r值分彆為0.60和0.41,P值均＜0.01;與A/V也均有相關性,r值分彆為0.60和0.52,P值均＜0.01.結論 胰泌素增彊MRCP聯閤胰腺常規MR掃描可以從形態和功能方麵診斷CP,為臨床診斷提供參攷.
목적 탐토이비소증강MR이담관성상(MRCP)연합상규이선MRI대만성이선염(CP)진단적개치.방법 수집17명건강지원자화36례CP환자재주사이비소전후다기MRCP화관상면T2 WI、상규이선평소화증강MR자료.관찰주사이비소전후적이관변화,이선외분비공능적평고채용십이지장충영도분급법,측량평소시이선여동층면좌측요대기적신호강도비(SIR)화증강소묘시이선실질기화연지기동층면신호강도비치(A/V)래관찰이선실질MR특정.장53례수시자안조건강지원조화CP환자불동검교분급진행분조,병안조십이지장충영정상화이상진행분조,관찰SIR화A/V.채용단인소방차분석비교건강지원자화CP환자불동검교분급각조환자적SIR화A/V치.십이지장내충영정상조화이상조SIR화A/V치적비교채용독립양본t검험.검교분급、십이지장충영도분급여SIR、A/V지간상관성분석채용Spearman질상관검험.결과 이비소주사후소유수시자주이관화분지이관균교주사전도상질량제고,17명건강지원자중균미견분지이관현시.주사이비소11 min후,17명건강지원자십이지장충영균위3급,36례CP환자중십이지장내충영3급、2급、1급자분별위23、8화5례.의거검교분급,CP경도、중도화중도환자분별위11、12화13례,건강지원조、CP경도조、CP중도조화CP중도조SIR치분별위1.21 ±0.19、1.07 ±0.21、0.98 ±0.21화0.85 ±0.18,A/V치분별위1.15 ±0.11、1.23±0.34、0.97 ±0.16화0.91 ±0.12,차이균유통계학의의(F치분별위8.72화7.72,P치균＜0.01).십이지장충영정상조화이상조환자분별위40화13례,SIR분별위1.09 ±0.20화0.88±0.27,A/V분별위1.15 ±0.11화0.94±0.30,차이균유통계학의의(t치분별위3.10화-2.40,P치균＜0.05).검교분급、십이지장충영도분급여SIR치유상관성,r치분별위0.60화0.41,P치균＜0.01;여A/V야균유상관성,r치분별위0.60화0.52,P치균＜0.01.결론 이비소증강MRCP연합이선상규MR소묘가이종형태화공능방면진단CP,위림상진단제공삼고.
Objective To discuss the value of combining secretin-enhanced MR cholangiopancreatography (MRCP) and conventional MRI in the evaluation of chronic pancreatitis (CP).Methods Seventeen normal volunteers,and 36 patients with CP were enrolled in this study.Thick slab two dimension MRCP sequence,coronal T2 weighted sequence and conventional MRI were performed on all subjects.The changes of pancreatic ducts were observed before and after the injection of secretin.The exocrine function of the pancreas was evaluated using duodenal filling (DF) grades.Pancreatic parenchyma was reflected by signal intensity ratio (SIR) between the pancreas and the left psoas muscle on MR plain scan,and the ratio between the pancreatic substance phase and portal phase (A/V) of MR enhanced scan.All subjects were classified based on Cambridge classification and DF grades.The SIR and A/V were compared between all groups of Cambridge classification using the one-way ANOVA test,and between two groups of DF grades using Student's t test.Correlations between Cambridge classifications,DF grades and SIR,A/V were tested using Spearman rank correlation coefficients.Results After secretin injection,the visualization of all portions of the main pancreatic ducts and branch ducts were significantly improved in all subjects.Ten minutes after secretin injection,17 volunteers showed grade 3.Grade 3,2 and 1 were seen in 23,8,5 patients,respectively.Mild,moderate and severe CP by Cambridge classification showed in 11,12,13 patients,respectively.The mean SIR values of the volunteers and the three groups were 1.21 ± 0.19,1.07 ±0.21,0.98 ± 0.21 and 0.85 ± 0.18,respectively; the mean A/V values:1.15 ± 0.11,1.23 ± 0.34,0.97 ± 0.16 and 0.91 ± 0.12.There was statistically significant difference of SIR and A/V (F =8.72 and 7.72,P ＜0.01) between volunteers and CP.Normal and abnormal DF were seen in 40 and 13 patients.The mean SIR values of the two groups were 1.09 ± 0.20 and 0.88 ± 0.27 ; the mean A/V values:1.15 ± 0.11 and 0.94 ± 0.30.There was statistically significant difference of SIR and A/V (t =3.10 and -2.40,P ＜ 0.01) between two groups.There were correlations between Cambridge classification,DF grades and SIR (r =0.60 and 0.41,P＜0.01),A/V (r =0.60 and 0.52,P＜0.01).Conclusion Secretin-enhanced MRCP combined with conventional MRI can be used to evaluate CP regarding changes of morphology and function,which can provide a useful reference for the clinical diagnosis.
