摘要
目的:探讨磁共振扩散峰度成像(DKI)在急性胰腺炎(acute pancreatitis,AP)的诊断及严重程度分级中的应用价值。方法:按诊断标准、纳入标准及排除标准前瞻性收集57例AP患者为研究组(AP组),同期收集健康志愿者24例作为对照组(NP组),两组均行上腹部常规MRI和多b值DKI检查(b值取0、1000、2000 s/mm^2)。根据改良MR严重指数(MRSI)评分标准将AP组分为轻症、中重症及重症三个亚组。测量所有对象的DKI参数平均峰度(MK)、轴向峰度(Ka)、径向峰度(Kr)及其衍生参数各向异性分数(FA)、平均扩散(MD)、轴向扩散(Da)、径向扩散(Dr),比较各参数在AP组与NP组间,轻症、中重症及重症AP组间的差异。绘制各参数的ROC曲线,评价各参数评估AP严重程度分级的诊断效能。结果:57例AP中,轻症24例,中重症27例,重症6例。AP组与NP组间,MK、Ka、MD、Da、Dr均存在统计学差异(P=0.033、0.000、0.000、0.000、0.000),而FA、Kr均无统计学差异(Z=1.798,P=0.072;Z=0.186,P=0.852)。MK仅在轻症与中重症AP间存在统计学差异(Z=2.442,P=0.015),其余参数在轻症与中重症AP间,轻症与重症AP间均存在统计学差异(P均<0.05),各参数在中重症与重症AP间均无统计学差异(P均>0.05)。MK、Ka、Kr随严重程度加重而增加,而FA、MD、Da、Dr随严重程度加重而减小。Ka评估AP严重程度分级的诊断效能最大,其ROC曲线下面积(AUC)最大(0.743),敏感度为78.310%,特异度为75.000%。结论:DKI技术有助于AP的诊断,且对AP严重程度分级具有一定的临床价值,其中Ka的诊断效能较大。
Objective:To explore the value of diffusion kurtosis imaging(DKI)in the severity grading of acute pancreatitis(AP).Methods:57 patients with AP and 24 healthy volunteers were included in this prospective study.All subjects underwent upper abdominal MRI including DKI(b values:0,1000,2000s/mm 2).The following parameters were determined including mean kurtosis(MK),axial kurtosis(Ka),radical kurtosis(Kr),fractional anisotropy(FA),mean diffusivity(MD),axial diffusivity(Da),and radial diffusivity(Dr).The paraeters were compared between the AP and the normal group,and among the different severity in the AP group.Results:Among the 57 AP cases,24 were mild,27 were moderate,and 6 were severe.There were statistically significant differences in MK,Ka and MD,Da,Dr between the AP and normal group(P=0.033,0.000,0.000,0.000,0.000,respectively).There were no statistically significant difference in FA,Kr(Z=1.798,P=0.072 and Z=0.186,P=0.852)between the above groups.There were statistically differences between the mild and the moderate in MK(Z=2.442,P=0.015).Significant differences also existed in the remaining parameters between the mild and the moderate,the mild and the severe AP group;there was no statistical difference in all parameters between the moderate and the severe AP group.As the severity of AP increased,the MK,Ka,Kr increased,while the FA,MD,Da,Dr decreased.Ka showed the best performance for severity grading of AP with AUC of 0.743,sensitivity of 78.3%,and specificity of 75%.Conclusion:DKI is valuable in the diagnosis and severity assessment of AP.
作者
徐红霞
黄小华
刘梦苓
匡静
成涛
刘翠兰
XU Hong-xia;HUANG Xiao-hua;LIU Meng-ling(Depatment of Radiology,Affiliated Hospital of North Sichuan Medical College,Sichuan Key Laboratory of Medical Imaging,Sichuan 637000,China)
出处
《放射学实践》
北大核心
2019年第2期167-173,共7页
Radiologic Practice
基金
四川省教育厅基金项目(16ZA0228)
关键词
扩散峰度成像
磁共振成像
急性胰腺炎
胰腺炎
MRSI
平均峰度
各向异性分数
Diffusion kurtosis imaging
Magnetic resonance imaging
Acute pancreatitis
Pancreatitis
Magnetic resonance severity index
Mean kurtosis
Fractional anisotropy
