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目的 :比较Mn -DPDP增强与Gd -DTPA动态增强对胰腺癌的显示及可切除性评价的价值。材料和方法 :22例拟手术的胰腺癌患者进入本研究 ,行常规平扫及Gd -DTPA动态增强 ,次日经肘静脉滴注Mn -DPDP(0.5ml/kg) ,于给药结束后30min以及24h行SET1W及SPGRT1W扫描。测量肿瘤、正常胰腺以及噪声信号强度。由两位医生独立阅读平扫、Mn -DPDP增强及Gd -DTPA动态增强三组图像 ,19例手术患者读片结果与手术资料比较 ,采用ROC分析评价三者的诊断效率。结果 :胰腺 -肿瘤CNR于给药结束后30min高于平扫(p<0.05)。Mn -DPDP增强给药结束后30min扫描SPGRT1W图像胰腺 -肿瘤CNR(15.49±.13)略低于Gd -DTPA动态增强动脉期的20.05±9.05 ,但两者间差异无统计学意义(p>0.05) ;高于门脉期的7.46±14.25和延迟期的2.16±15.38(p<0.05)。平扫、Mn -DPDP增强及Gd -DTPA动态增强对胰腺癌可切除性评价准确性分别为47.9 %～57.9 %、78.9 %～84.2 %和84.2 %～89.5 %。ROC分析表明 :Mn -DPDP增强对胰腺癌可切除性评价帮助不大。结论 :Mn -DPDP增强能增加胰腺 -肿瘤CNR ,与Gd -DTPA动态增强动脉期相似 ,可以提高诊断可信度 ;对胰腺癌可切除性评价价值不大
OBJECTIVE: To compare the display of Mn-DPDP and Gd-DTPA dynamic enhancement in the evaluation of resectability of pancreatic carcinoma. MATERIALS AND METHODS: Twenty-two patients undergoing pancreatic surgery were enrolled in this study. Conventional plain scan and dynamic Gd-DTPA enhancement were performed. The next day, Mn-DPDP (0.5ml / kg) And SET1W and SPGRT1W scanning for 24h. Tumor, normal pancreas and noise signal intensity were measured. Two doctors independently read the plain scan, Mn-DPDP enhanced and Gd-DTPA dynamic enhanced three images, 19 cases of surgical patients reading results and surgical data, the use of ROC analysis to evaluate the diagnostic efficiency of the three. Results: The pancreatic-tumor CNR was higher than that at 30 minutes after the end of treatment (p <0.05). The pancreatic-tumor CNR (15.49 ± 13.) in the SPGRT1W scan 30 min after Mn-DPDP enhancement was slightly lower than that of the Gd-DTPA dynamic enhancement arterial phase 20.05 ± 9.05, but there was no significant difference between the two groups (p> 0.05 ); 7.46 ± 14.25 higher than portal phase and 2.16 ± 15.38 delayed phase (p <0.05). The accuracy of plain scan, Mn-DPDP and Gd-DTPA dynamic enhancement in resectability of pancreatic cancer were 47.9% -57.9%, 78.9% -84.2% and 84.2% -89.5%, respectively. ROC analysis showed that: Mn-DPDP enhanced pancreatic resectability evaluation will not help. Conclusion: Increased Mn-DPDP can increase the pancreatic-tumor CNR, which is similar to the Gd-DTPA dynamic enhanced arterial phase, which can improve the reliability of diagnosis. The evaluation of resectability of pancreatic cancer is not significant