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目的:分析表观弥散系数(ADC)值联合动态增强磁共振成像(MRI)时间-信号强度曲线(TIC)在胰腺癌的诊断及鉴别诊断中的应用价值。方法:回顾性抽取2019年7月至2021年7月太原钢铁(集团)有限公司总医院收治的30例胰腺癌患者、30例肿块型胰腺炎患者作为胰腺癌组和胰腺炎组,另以胰腺癌或肿块性胰腺患者的正常胰腺实质作为胰腺正常组(60例)。分析胰腺癌组和胰腺炎组患者的MRI常规序列与动态增强表现,统计分析三组的弥散加权成像(DWI)表现与ADC值、TIC分布情况。结果:胰腺癌组T1加权成像(T1WI)病灶主要呈低信号,其次呈混杂信号或等信号;T2加权成像(T2WI)病灶主要呈稍高信号;MRI增强扫描肿块强化,缓慢上升,门脉期强化显著,动脉期强化不显著。胰腺炎组T1WI病灶主要呈等信号和低信号;T2WI病灶主要呈等信号或稍高信号,不均匀;MRI增强扫描病灶动脉期强化不显著,增强后期肿块强化程度高于邻近组织。胰腺癌组ADC值高于胰腺炎组(n P<0.05),胰腺癌组、胰腺炎组ADC值均低于胰腺正常组(n P均<0.05)。胰腺癌组TIC缓慢上升更缓慢流出型比例高于胰腺炎组及胰腺正常组(n P<0.05);胰腺癌组TIC逐渐上升型比例低于胰腺炎组(n P<0.05),高于胰腺正常组(n P<0.05);胰腺炎组TIC逐渐上升型比例高于胰腺正常组(n P<0.05);胰腺癌组TIC速升速降型比例低于胰腺炎组及胰腺正常组(n P<0.05),胰腺炎组TIC速升速降型比例低于胰腺正常组(n P<0.05)。n 结论:胰腺癌的诊断及鉴别诊断中,ADC值联合动态增强MRI的TIC价值高。“,”Objective:To analyze the application of apparent diffusion coefficient (ADC) value combined with dynamic enhanced magnetic resonance imaging (MRI) time signal intensity curve (TIC) in the diagnosis and differential diagnosis of pancreatic cancer.Methods:Thirty patients with pancreatic cancer and 30 patients with mass pancreatitis admitted to the General Hospital of Taiyuan Iron and Steel (Group) Co., Ltd. from July 2019 to July 2021 were retrospectively selected as pancreatic cancer group and pancreatitis group. Normal pancreatic parenchyma of pancreatic cancer or mass pancreas was used as normal pancreas group (60 cases). The MRI routine sequence and dynamic enhanced expression of the patients in pancreatic cancer group and pancreatitis group were analyzed. The distribution of diffusion weighted imaging (DWI), ADC and TIC distribution of the three groups were statistically analyzed.Results:The T1 weighted imaging (T1WI) of lesions in pancreatic cancer group mainly showed low signal, followed by mixed signal or equal signal. T2 weighted imaging (T2WI) of lesions in pancreatic cancer group showed slightly high signal intensity. On contrast-enhanced MRI in pancreatic cancer group, the mass was enhanced and increased slowly, with significant enhancement in portal phase and no significant enhancement in arterial phase. The T1WI of lesions in pancreatitis group were mainly isointense and hypointense; while T2WI lesions were mainly isointense or slightly hyperintense and uneven. On contrast-enhanced MRI in pancreatitis group, the enhancement of the lesion in arterial phase was not significant, and the enhancement degree of the mass in the later stage was higher than that of the adjacent tissue. The ADC value of the pancreatic cancer group was higher than that of the pancreatitis group (n P<0.05). The ADC values of pancreatic cancer group and pancreatitis group were all lower than those of normal pancreas group (alln P<0.05). The ratio of TIC with slow type progressing into slower outflow type of the pancreatic cancer group was higher than that of the pancreatitis group and the normal pancreas group (n P<0.05). The ratio of TIC with gradually rising type of the pancreatic cancer group was slower than that of the pancreatitis group (n P<0.05), which was higher than that of the normal pancreas group (n P<0.05). The ratio of TIC with gradually rising type of the pancreatitis group was slower than that of the normal pancreas group (n P<0.05). In the pancreatic cancer group, the rate of TIC with fast speed up and down type was lower than that in the pancreatitis group and the normal pancreas group (n P<0.05), and the rate of TIC with fast speed up and down type in the pancreatitis group was lower than that in the normal pancreas group (n P<0.05).n Conclusions:The TIC value of ADC combined with dynamic enhanced MRI is of high value in the diagnosis and differential diagnosis of pancreatic cancer.