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目的:探讨MRI扩散加权成像(DWI)在2型糖尿病患者的胰腺检查应用价值。方法:取纳入标准的75例2型糖尿病患者,根据病程分为三组:<2年、2~10年、>10年。同时选取25例健康人群作为健康对照组。采用MRI平扫、多期动态增强扫描及DWI检查测量患者胰腺的扩散系数(ADC),观察糖尿病患者胰腺的MRI及DWI信号表现特征。结果:DWI检查测量健康对照组、糖尿病<2年、2~10年、>10年三组患者胰腺体部的ADC值,取b值500 mm~2/s时,分别测量每组的ADC均值为(2.00±0.17)×10~(-3) mm~2/s,(1.94±0.09)×10-3 mm~2/s,(1.86±0.13)×10~(-3)mm~2/s,(1.77±0.25)×10-3 mm~2/s,与健康对照组相比,P值分别为0.023、0.010、0.008,两者差异具有统计学意义(P<0.05)。75例糖尿病患者MRI检查胰腺,1例追踪确诊为胰腺癌。结论:糖尿病患者胰腺DWI信号随病程延长而逐渐变化,能反应胰腺细胞功能改变,具有一定的临床参考价值,具有对早期单纯表现为糖尿病的胰腺癌患者进行筛查的潜能。
Objective: To investigate the value of MRI diffusion-weighted imaging (DWI) in pancreatic examination in type 2 diabetic patients. Methods: 75 patients with type 2 diabetes mellitus admitted to the standard were divided into three groups according to their course of disease: <2 years, 2 to 10 years,> 10 years. At the same time, 25 healthy people were selected as healthy control group. The pancreatic diffusion coefficient (ADC) of the pancreas was measured by plain MRI, multi-phase dynamic contrast-enhanced scanning and DWI, and the MRI and DWI signal characteristics of pancreas in diabetic patients were observed. Results: DWI was used to measure the ADC value of pancreatic body in healthy control group, diabetes <2 years, 2 ~ 10 years,> 10 years. The ADC value of each group was measured with b value of 500 mm ~ 2 / s (2.00 ± 0.17) × 10 ~ (-3) mm ~ 2 / s, (1.94 ± 0.09) × 10-3 mm ~ 2 / s and (1.86 ± 0.13) × 10 ~ (-3) mm ~ 2 / s, (1.77 ± 0.25) × 10-3 mm ~ 2 / s, respectively. Compared with healthy control group, the P values were 0.023,0.010 and 0.008, respectively. There was significant difference between the two groups (P <0.05). 75 cases of diabetic patients with MRI examination of the pancreas, 1 case of follow-up diagnosed as pancreatic cancer. CONCLUSION: The DWI signal in diabetic patients gradually changes with the prolongation of the course, which can reflect the change of function of pancreatic cells. It has certain clinical reference value and has the potential to screen the patients with early-stage simple pancreatic cancer with simple diabetes.