DWI鉴别自身免疫性胰腺炎与胰腺癌的价值

发布时间：2018-03-08 12:30

本文选题：扩散加权成像　切入点：表观扩散系数　出处：《临床放射学杂志》2015年01期 　论文类型：期刊论文

【摘要】：目的探讨扩散加权成像(DWI)鉴别自身免疫性胰腺炎(AIP)与胰腺癌(PAC)的应用价值及对AIP患者疗效的评估。方法 9例AIP患者、10例PAC患者以及同期10名正常胰腺(NP)对照组均行DWI扫描,其中2例AIP于治疗后复查DWI,比较AIP与PAC及AIP治疗前后的DWI表现(包括病灶的大小、形态、累及范围);比较AIP组、PAC组及NP组表观扩散系数(ADC)值并绘制ADC值鉴别AIP与PAC的受试者工作特征(ROC)曲线。结果 AIP组与PAC组在DWI上均呈高信号,AIP组高信号区以弥漫性为主(6/9),形态主要呈"腊肠"样(8/9);PAC组以局灶性为主(9/10),形态主要呈肿块型(9/10),两者差异有统计学意义(P0.05)。AIP组ADC值[(0.944±0.096)×10-3mm2/s]明显低于PAC[(1.333±0.186)×10-3mm2/s]组及NP组[(1.372±0.195)×10-3mm2/s](P值均0.001);PAC与NP组间差异无统计学意义(P=0.8720.05)。ADC鉴别AIP与PAC临界值为1.051×10-3mm2/s,ROC曲线下面积为0.978。2例AIP经激素治疗后复查DWI示胰腺体积缩小,信号减低,ADC值升高。结论 DWI有助于AIP与PAC的鉴别诊断,并可作为AIP患者疗效评估的方法之一。
[Abstract]:Objective to evaluate the clinical value of diffusion-weighted imaging (DWI) in differentiating autoimmune pancreatitis (AIP) from pancreatic carcinoma (PA) and to evaluate the efficacy of DWI in AIP. Methods 9 patients with AIP and 10 patients with PAC and 10 normal controls were examined with DWI. Two cases of AIP were examined with DWI after treatment. DWI findings (including the size and morphology of lesions) before and after treatment with AIP, PAC and AIP were compared. The apparent diffusion coefficients of AIP group and NP group were compared and the operating characteristics of AIP and PAC were drawn. Results both AIP group and PAC group showed high signal on DWI. It was mainly "sausage" like 8 / 9 / 9% PAC group, mainly localized 9 / 10%, and the shape was mainly mass type 9 / 10%, the difference was statistically significant (P < 0. 044 卤0. 096) 脳 10 ~ (-3) mm ~ 2 / s, which was significantly lower than that of PAC [1. 333 卤0. 186) 脳 10 ~ (-3) mm ~ (2) s] and NP group [1. 372 卤0. 195 脳 10 ~ (-3) mm ~ 2 / s] P. The critical value of AIP and PAC was 1.051 脳 10 ~ (-3) mm ~ (-2) / s ~ (-1) ROC curve. The area under the curve of 0.978.2 cases of AIP showed that the volume of pancreas was reduced after hormone therapy. Conclusion DWI is helpful to the differential diagnosis of AIP and PAC and can be used as one of the methods to evaluate the curative effect of AIP.
【作者单位】：福建医科大学附属第一医院影像科;
【分类号】：R735.9;R576;R445.2

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