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目的探讨联合运用3D-LAVA和DWI技术在胰腺癌的诊断中的价值。方法回顾性分析经手术病理证实的24例胰腺癌的MRI图像。扫描序列为:平扫压脂序列(T1WI,T2WI)、LAVA动态增强序列、DWI,分析其MRI表现。包括:对各序列图像质量进行评分;测量胰腺癌与正常胰腺组织的信号强度比SIR;比较胰腺癌、非癌胰腺组织的ADC值是否有差异;比较不同序列及LAVA联合DWI序列对胰腺癌的检出率和准确性;利用LAVA动态增强评估胰周血管受侵情况并将MRI评价结果与手术病理对照。结果LAVA动态增强扫描图像质量最好(P<0.05);LAVA动态增强扫描动脉期和DWI的SIR高于其他序列(P<0.05);胰腺癌与非癌胰腺组织ADC值的x-±s具有显著性差异;LAVA多期动态增强扫描结合DWI序列对胰腺癌的检出率和准确性与单一序列相比差异具有统计学意义;16例LAVA动态增强判断血管受侵的患者,与手术中所见误诊3条血管,准确率为87.5%。结论LAVA动态增强序列能够比较完美地实现胰腺的多期动态增强扫描,结合DWI序列对胰腺癌的显示、定性诊断与及术前可切除性的评价具有重要意义。
Objective To investigate the value of 3D-LAVA and DWI in the diagnosis of pancreatic cancer. Methods The MRI images of 24 cases of pancreatic carcinoma confirmed by surgery and pathology were retrospectively analyzed. The scanning sequences were: pressolase sequence (T1WI, T2WI), dynamic enhancement sequence of LAVA, DWI, MRI features. Including the following: scoring the image quality of each sequence; measuring the signal intensity ratio (SIR) between pancreatic cancer and normal pancreatic tissue; comparing the ADC value of pancreatic cancer and non-cancerous pancreatic tissue whether there is a difference; comparing different sequences and LAVA combined DWI sequence to pancreatic cancer Detection rate and accuracy; using LAVA dynamic enhanced assessment of peripancreatic vascular invasion and MRI evaluation results and surgical pathology. Results The LAVA dynamic enhancement scan image quality was the best (P <0.05); LAVA dynamic enhanced scan arterial phase and DWI SIR higher than other sequences (P <0.05); pancreatic and non-cancerous pancreatic ADC value of x- ± s has Significant difference; LAVA multi-phase dynamic contrast-enhanced scan combined with DWI sequence detection rate and accuracy of pancreatic cancer compared with a single sequence was statistically significant; 16 cases of LAVA dynamic assessment of vascular invasion of patients, and surgery See misdiagnosed 3 blood vessels, the accuracy rate of 87.5%. Conclusions The dynamic enhancement sequence of LAVA can perfectly realize the multi-phase dynamic contrast-enhanced scanning of the pancreas. It is of great significance to combine the DWI sequence to display the pancreatic cancer qualitatively and evaluate the preoperative resectability.