经胰泌素刺激核磁共振成像评价胰腺外分泌功能的研究

发布时间：2018-12-13 18:00

【摘要】：目的：利用胰泌素刺激胰胆管成像(MRCP)技术和磁共振弥散加权成像(DWI)技术评价正常人胰腺外分泌功能。方法：受试者为30名健康志愿者。所有健康志愿者均采用体外校准器法进行30分钟扫描。MRCP检查采用单次激发半傅里叶采集快速自旋回波序列(HASTE),DWI采用自旋回波-回波平面成像技术(EPI),弥散梯度b值分别为0,400s/mm2。注射胰泌素前扫描MRCP.T2冠状位和DWI序列作为对照,然后加校准器扫描一次MRCP序列作为蒙片。注射胰泌素后前1Omin以1min为间隔重复扫描MRCP及T2冠状位。之后以2min为间隔扫描MRCP及T2冠状位序列至第30分钟。DWI序列在第10min开始,以5分钟间隔扫描至第30min,胰泌素的注射量为8mcg。所得全部图像通过磁共振后处理系统进行收集及处理分析。计算各组数据的均值与标准差,对比注射胰泌素前后数据的变化,并进行相关统计学分析。结果：健康人群注射胰泌素后胰液可持续分泌。胰管在第(2.7±0.9)min扩张并达到最大值后逐渐恢复到基础值,对比注药前胰管管径与注药后胰管最大径,通过配对样本T检验胰头、胰体及胰尾管径P0.05,证实有统计学差异。胰液分泌峰值的时间为(24.9±4.4)min,最大分泌量为(91.2±43.2)ml,第一次最大分泌增量时间为(3.7±2.4)min,最大分泌增量为(12.7±5.1)ml,第二次最大分泌增量时间为(15.4±5.7)min,最大分泌增量为(14.5±10.2)ml。通过胰液-时间曲线可发现15min内胰液的分泌量与注射胰泌素的时间呈直线回归关系,经相关性分析pearson检验p0.01呈显著相关。绘制30min内胰泌素分泌量与时间的分泌趋势发现二者可以用二次曲线回归方程进行拟合,并且在25.64min为转折点开始呈下降趋势。胰液在十二指肠充盈程度达到3级的时间为(10.8±2.4)min,10min后胰液逐步充盈十二指肠,空肠近段及中远端。注射药前胰腺ADC值：(2.39±0.26)x10-3mm2/s2、注药后：10min:(2.42±0.31)x10-3mm2/s2、15min:(2.38±0.25)x10-3mm2/s2、20min:(2.40±0.22)x10-3mm2/s2、25min:(2.44±0.18)x10-3mm2/s2、30min:(2.50±0.13) x10-3mm2/s2。通过配对样本T检验.P0.05,注药前后无统计学差异。注药前胰腺与肝脏的比值rADC值：(1.15±0.13)x10-3mm2/s2,注药后rADC:10min:(1.19±0.15) x10-3mm/s2、15min:(1.18±0.20)x10-3mm2/s2、20min:(1.17±0.88)x10-3mm2/s、25min:(1.14±0.10)x10-3mm2/s2、30min:(1.22±0.27)x10-3mm2/s2。通过配对样本T检验P0.05,注药前后rADC值无统计学差异。结论：胰泌素刺激胰胆管成像技术和弥散加权成像技术可以评价正常人胰腺外分泌功能；注射胰泌素后胰液会达到峰值后逐渐恢复到基础状态；注射胰泌素前后胰腺ADC值及rADC值无变化。
[Abstract]:Aim: to evaluate the exocrine function of normal pancreas by using pancreatic secretion stimulating cholangiopancreatography (MRCP) and magnetic resonance diffusion-weighted imaging (DWI). Methods: the subjects were 30 healthy volunteers. All healthy volunteers were scanned with an extracorporeal calibrator for 30 minutes. MRCP was performed with single excitation half Fourier transform acquisition of fast spin echo sequence (HASTE), DWI and spin echo plane imaging technique (EPI), The dispersion gradient b is 0 400 s / m 2. The MRCP.T2 coronal position and DWI sequence were compared before injection of pancreatic secretin, and then the MRCP sequence was scanned by a calibrator. MRCP and T 2 coronal scanning were performed on 1Omin with 1min interval before injection of pancreatic secretin. Then MRCP and T2 coronal sequence were scanned at 2min interval to 30 minutes. DWI sequence began at 10min and was scanned at 5 minutes interval to 30 min. The injection amount of secretin was 8mcg. All the images were collected and analyzed by magnetic resonance postprocessing system. The mean value and standard deviation of each group were calculated, and the changes of the data before and after injection of pancreatic secretin were compared, and the correlation statistical analysis was carried out. Results: pancreatic juice can be secreted continuously after injection of pancreatic secretin in healthy people. The pancreatic duct was gradually restored to its base value after (2. 7 卤0. 9) min dilated and reached its maximum value. The diameter of pancreatic duct before and after injection was compared with the maximum diameter of pancreatic duct after injection. The diameter of pancreatic head, body and tail of pancreas was examined by paired sample T. Statistical differences were confirmed. The time of peak secretion of pancreatic juice is (24.9 卤4.4) min, maximum secretion is (91.2 卤43.2) ml, the first maximum secretion increment time is (3.7 卤2.4) min, maximum secretion increment is (12.7 卤5.1) ml,. The second maximum secretion increment time is (15.4 卤5.7) min, the maximum secretion increment is (14.5 卤10.2) ml.. It was found that the secretion of pancreatic juice in 15min had a linear regression relationship with the time of injection of pancreatic secretin, and the correlation analysis showed that there was a significant correlation between the secretion of pancreatic juice and the time of injection of pancreatic secretin by pearson test (p0.01). It was found that the secretory amount and time of pancreatic secretion in 30min could be fitted by quadratic regression equation, and that they had a decreasing trend at the turning point of 25.64min. The time of pancreatic juice filling in the duodenum was (10.8 卤2.4) min,10min. The pancreatic juice gradually filled the duodenum, proximal jejunum and middle and distal part of the jejunum. ADC of pancreas before injection: (2.39 卤0.26) x 10-3 mm 2 / s 2, 10 min: (2.42 卤0.31) x 10-3 mm 2 / s 2 15 min: (2.38 卤0.25) x 10 -3 mm 2 / s 2 min 20 min: (2.40 卤0.22) x 10 -3 mm 2 / s 225 min: (2.44 卤0.18) x 10 -3 mm 2 / s 230min: (2.50 卤0.13) x 10 -3 mm 2 / s 2 / 2. There was no statistical difference before and after injection of P0.05 by T test of paired samples. The ratio of pancreas to liver rADC before injection was (1.15 卤0.13) x 10-3 mm 2 / s 2, and after injection rADC:10min: was (1.19 卤0.15) x 10 -3 mm 路s 2 min: (1.18 卤0.20) x 10 -3 mm 2 / s 2 min: (1.17 卤0.88) x 10 -3 mm 2 路s 2 路s, 25 min: (1.14 卤0.10) x 10-3 mm 2 / s 230 min: (1.22 卤0.27) x 10 -3 mm 2 / s 2. There was no significant difference in rADC before and after injection by paired T test (P 0.05). Conclusion: pancreatic secretin stimulating cholangiopancreatography and diffusion-weighted imaging can evaluate the exocrine function of normal pancreas, and the pancreatic juice will gradually recover to the basic state after the injection of pancreatic secretin. There was no change in pancreatic ADC and rADC values before and after injection of pancreatic secretin.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2

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