中国临床医学
中國臨床醫學
중국림상의학
CLINICAL MEDICAL JOURNAL OF CHINA
2014年
5期
543-545
,共3页
冯豪%许红莲%顾俊英%姚秀忠
馮豪%許紅蓮%顧俊英%姚秀忠
풍호%허홍련%고준영%요수충
胰腺癌%胰腺炎%3.0T 磁共振成像%扩散加权成像%表观弥散系数
胰腺癌%胰腺炎%3.0T 磁共振成像%擴散加權成像%錶觀瀰散繫數
이선암%이선염%3.0T 자공진성상%확산가권성상%표관미산계수
Pancreatic cancer%Pancreatitis%3.0T magnetic resonance imaging%Diffusion-weighted imaging%Apparent diffusion coefficient
目的：分析比较呼吸门控脂肪抑制弥散加权成像（diffusion weighted imaging，DWI）与憋气 DWI 在胰腺癌和肿块型胰腺炎中的鉴别诊断价值。方法：回顾分析经手术病理确诊的30例胰腺癌与17例肿块型胰腺炎患者术前行3．0T 磁共振 DWI检查的资料。DWI 基于自旋回波-回波平面成像（SE-EPI）序列，包括憋气 DWI 和呼吸门控脂肪抑制 DWI 序列，b 值为600 s／mm2。分析比较胰腺癌及肿块型胰腺炎的表观弥散系数（apparent diffusion coefficient，ADC）。采用受试者工作特征（receiver operating characteristic，ROC）曲线分析比较2种 DWI 序列鉴别诊断胰腺癌及肿块型胰腺炎的效能。结果：在憋气 DWI 序列上，胰腺癌与肿块型胰腺炎 ADC 值差异无统计学意义（P ＞0．05）；在呼吸门控脂肪抑制 DWI 序列上，胰腺癌与肿块型胰腺炎的 ADC 值差异有统计学意义（P ＜0．01）。在呼吸门控脂肪抑制 DWI 序列中，以 ADC≥1．33×10-3 mm2／s 为诊断阀值从肿块型胰腺炎中鉴别诊断胰腺癌，灵敏度和特异度分别为86．7％和88．9％，阳性预测值和阴性预测值分别为96．3％和66．7％。在憋气 DWI 序列中，以 ADC 值≥1．45×10-3 mm2／s 为诊断阀值从肿块型胰腺炎中鉴别诊断胰腺癌，灵敏度和特异度分别为73．3％和88．9％，阳性预测值和阴性预测值分别为95．7％和50．0％。结论：与憋气 DWI 比较，呼吸门控脂肪抑制 DWI 序列对胰腺癌和肿块型胰腺炎的鉴别诊断价值更高。
目的：分析比較呼吸門控脂肪抑製瀰散加權成像（diffusion weighted imaging，DWI）與憋氣 DWI 在胰腺癌和腫塊型胰腺炎中的鑒彆診斷價值。方法：迴顧分析經手術病理確診的30例胰腺癌與17例腫塊型胰腺炎患者術前行3．0T 磁共振 DWI檢查的資料。DWI 基于自鏇迴波-迴波平麵成像（SE-EPI）序列，包括憋氣 DWI 和呼吸門控脂肪抑製 DWI 序列，b 值為600 s／mm2。分析比較胰腺癌及腫塊型胰腺炎的錶觀瀰散繫數（apparent diffusion coefficient，ADC）。採用受試者工作特徵（receiver operating characteristic，ROC）麯線分析比較2種 DWI 序列鑒彆診斷胰腺癌及腫塊型胰腺炎的效能。結果：在憋氣 DWI 序列上，胰腺癌與腫塊型胰腺炎 ADC 值差異無統計學意義（P ＞0．05）；在呼吸門控脂肪抑製 DWI 序列上，胰腺癌與腫塊型胰腺炎的 ADC 值差異有統計學意義（P ＜0．01）。在呼吸門控脂肪抑製 DWI 序列中，以 ADC≥1．33×10-3 mm2／s 為診斷閥值從腫塊型胰腺炎中鑒彆診斷胰腺癌，靈敏度和特異度分彆為86．7％和88．9％，暘性預測值和陰性預測值分彆為96．3％和66．7％。在憋氣 DWI 序列中，以 ADC 值≥1．45×10-3 mm2／s 為診斷閥值從腫塊型胰腺炎中鑒彆診斷胰腺癌，靈敏度和特異度分彆為73．3％和88．9％，暘性預測值和陰性預測值分彆為95．7％和50．0％。結論：與憋氣 DWI 比較，呼吸門控脂肪抑製 DWI 序列對胰腺癌和腫塊型胰腺炎的鑒彆診斷價值更高。
목적：분석비교호흡문공지방억제미산가권성상（diffusion weighted imaging，DWI）여별기 DWI 재이선암화종괴형이선염중적감별진단개치。방법：회고분석경수술병리학진적30례이선암여17례종괴형이선염환자술전행3．0T 자공진 DWI검사적자료。DWI 기우자선회파-회파평면성상（SE-EPI）서렬，포괄별기 DWI 화호흡문공지방억제 DWI 서렬，b 치위600 s／mm2。분석비교이선암급종괴형이선염적표관미산계수（apparent diffusion coefficient，ADC）。채용수시자공작특정（receiver operating characteristic，ROC）곡선분석비교2충 DWI 서렬감별진단이선암급종괴형이선염적효능。결과：재별기 DWI 서렬상，이선암여종괴형이선염 ADC 치차이무통계학의의（P ＞0．05）；재호흡문공지방억제 DWI 서렬상，이선암여종괴형이선염적 ADC 치차이유통계학의의（P ＜0．01）。재호흡문공지방억제 DWI 서렬중，이 ADC≥1．33×10-3 mm2／s 위진단벌치종종괴형이선염중감별진단이선암，령민도화특이도분별위86．7％화88．9％，양성예측치화음성예측치분별위96．3％화66．7％。재별기 DWI 서렬중，이 ADC 치≥1．45×10-3 mm2／s 위진단벌치종종괴형이선염중감별진단이선암，령민도화특이도분별위73．3％화88．9％，양성예측치화음성예측치분별위95．7％화50．0％。결론：여별기 DWI 비교，호흡문공지방억제 DWI 서렬대이선암화종괴형이선염적감별진단개치경고。
Objective:To compare the value of respiratory-triggered diffusion-weighted imaging with fat suppression(RTIR-DWI)and common breath-hold DWI(BH-DWI)for the differential diagnosis of pancreatic cancer and mass-like pancreatitis. Methods:A total of 30 cases of pancreatic cancer and 17 cases of mass-like pancreatitis,which were confirmed by surgical pa-thology,underwent DWI at 3.0T before operation.DWI based on SE-EPI sequence,of which b value was 600 s/mm2 ,included BH-DWI and RTIR-DWI.Apparent diffusion coefficient(ADC)value of pancreatic cancer and mass-like pancreatitis were statis-tically analyzed and compared.Receiver operating characteristic(ROC)curve was used to analyze and compare the effect of two DWI sequences in the differential diagnosis of pancreatic cancer and mass-like pancreatitis.Results:On BH-DWI,ADC value did not have significant difference between pancreatic cancer and mass-like pancreatitis(P >0.05).On RTIR-DWI,ADC value had significant difference between pancreatic cancer and mass-like pancreatitis(P <0.01).On RTIR-DWI,the sensitivity,speci-ficity,positive predictive value and negative predictive value were 86.7%,88.9%,96.3% and 66.7%,respectively,when ADC≥1.33×10-3 mm2/s was used as a cutoff for the differential diagnosis of pancreatic cancer from mass-like pancreatitis.On BH-DWI,the sensitivity,specificity,positive predictive value and negative predictive value was 73.3%,88.9%,95.7% and 50.0%,respectively,when ADC≥ 1.45 × 10-3 mm2/s was used as a cutoff for the differential diagnosis of pancreatic cancer from mass-like pancreatitis.Conclusions:Compared to BH-DWI,RTIR-DWI may be more conducive to the diagnosis and differentiation of pancreatic cancer and mass-like pancreatitis.
