摘要
目的探讨MRI联合DWI鉴别胰腺小囊性病变良恶性的价值。方法回顾分析经病理证实46例胰腺小囊性占位病变影像资料,将其分为良性组(浆液性囊腺瘤、淋巴上皮囊肿、假性囊肿)及潜在恶性组(粘液性囊腺瘤、导管内乳头状瘤、实性假乳头状瘤),比较两组患者临床、影像数据。结果良性25例,潜在恶性21例。1)单因素分析:壁厚>3mm,囊壁结节,囊内实性成分,囊壁强化(动脉期高于周围胰腺实质),囊壁厚薄不均及ADC值差异有统计学意义; 2)多因素分析:上述6项影响因素曲线下面积(AUC)从小到大依次是:囊壁强化(0. 647)<囊壁不均匀(0. 674)<壁厚> 3mm(0. 742)<囊壁结节(0. 773)<囊内实性成分(0. 777)<ADC值(0. 886),ADC值价值最大,临界值为2. 57×10^(-3)mm^2/s(b=800s/mm^2)。结论胰腺小囊性占位病变影像学中发现壁厚> 3mm,囊壁结节,囊内实性成分,囊壁强化,囊壁厚薄不均及ADC值<2. 57×10^(-3)mm^2/s,提示病变为潜在恶性,同时结合临床,为下一步的治疗提供可靠的信息。
Objective To investigate the value of MRI combined with DWI in differentiating benign and malignant small cystic lesions of pancreas.Methods The imaging data of 46 cases that proved by pathology were retrospectively analyzed.The lesions were divided into benign and potentially malignant group.Results Among the 46 patients,25 were benign and 21 were latent malignancy.The results of univariate analysis showed that the differences in terms of thick wall,nural nodule,intracapsular solid component,wall enhancement,uneven wall,ADC value were statistically significant.The area under the above six influencing factor curves was from small to large:wall enhancement﹤uneven wall﹤thickne wall﹤nural nodule﹤intracapsular solid component﹤ADC value.The critical ADC value was 2.57×10^-3 mm^2/s.Conclusion If the lesion appears the thick wall,nural nodule,intracapsular solid component,wall enhancement,uneven wall and the ADC value﹤2.57×10^-3 mm^2/s,those indicate that the lesion is potentially malignant.
作者
范蒙
于金玉
巩若箴
任帅
王中秋
FAN Meng;YU Jinyu;GONG Ruozhen;Ren Shuai;WANG Zhongqiu(Department of Radiology,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210000,P.R.China;Wannan Medical College,Wuhu 241000,P.R.China;Shandong Medical Imaging Research Institute Affiliated to Shondong University,Jinan 250021,P.R.China)
出处
《医学影像学杂志》
2019年第1期144-147,共4页
Journal of Medical Imaging
基金
国家自然科学基金资助项目(编号:81471705
81771899)
江苏省重点研发项目(编号:BE2017772)
关键词
胰腺肿瘤
磁共振成像
扩散加权成像
Pancreatic neoplasms
Magnetic resonance imaging
Diffusion weighted imaging
