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目的探讨磁共振弥散加权成像(DWI)技术在胰腺疾病诊断中的应用价值。方法选取2015年6月至2016年10月辽宁省葫芦岛市第二人民医院收治的45例疑似胰腺疾病患者作为研究对象,患者均行DWI诊断,分别采用b为0、500及1000 s/mm2和b为50、200、400及600 s/mm2进行DWI扫描。结果经常规MRI检查6例未见异常,其余39例均观察到异常;39例患者中,13例胰腺局限性或弥漫性肿大,16例炎症与胰周渗出,7例胰管变粗,3例胸腔部位存在积液;恶性病变组患者b值差为1000及500 s/mm2时ADC值均明显高于胰腺正常组及胰腺良性病变组,差异均有统计学意义(均P<0.05);胰腺良性病变者b值差为1000及500 s/mm2时ADC值均明显高于胰腺正常组,差异均有统计学意义(均P<0.05);不同b值差下,胰腺正常与胰腺良性病变患者均表现为中等信号,与肝脏信号相似,但是信号强度低于脾脏信号(P<0.05);恶性病变患者中,8例表现为弥漫性均匀高信号,5例表现为不均匀高信号,2例表现为中等信号。结论胰腺疾病患者采用DWI检测能清晰的显示病灶部位及范围,与测量ADC相互结合能提高临床确诊率。
Objective To investigate the value of magnetic resonance diffusion-weighted imaging (DWI) in the diagnosis of pancreatic diseases. Methods Forty-five patients with suspected pancreatic diseases admitted to the Second People’s Hospital of Huludao City from June 2015 to October 2016 were enrolled in this study. All patients underwent DWI with b values of 0,500 and 1000 s / mm 2 And b for DWI scans of 50, 200, 400 and 600 s / mm2. Results There were no abnormalities in 6 cases by conventional MRI and the other 39 cases were abnormal. Among the 39 cases, 13 cases had localized or diffuse pancreas, 16 cases had inflammation and peripancreatic exudate, and 7 cases had pancreatic duct thickening , And there were effusions in 3 cases of thoracic cavity. ADC value of b value of 1000 and 500 s / mm2 in malignant group was significantly higher than that in normal group and benign pancreatic group (all P <0.05 ); Benign pancreatic lesions with b value difference of 1000 and 500 s / mm2 ADC values were significantly higher than the normal group, the difference was statistically significant (all P <0.05); different b value difference, the normal pancreas and pancreas Patients with benign lesions showed moderate signal, similar to liver signal, but lower signal intensity than spleen signal (P <0.05). Among malignant lesions, 8 showed diffuse homogeneous high signal and 5 showed non-uniform high signal , 2 cases showed a moderate signal. Conclusion DWI in patients with pancreatic diseases can clearly show the location and extent of the lesion. Combined with the measurement of ADC, it can improve the clinical diagnosis rate.