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目的评价动态磁共振增强扫描对胰腺癌及胰腺内分泌肿瘤的诊断价值。方法对术前均行磁共振平扫和动态增强扫描的22例胰腺癌和9例胰腺内分泌肿瘤的MR表现进行对照分析。结果22例胰腺癌(4例未见肿块),在FS-T1WI上呈低信号11例,略低信号6例,等信号1例;在FS-T2WI上呈高信号5例,稍高信号7例,等信号5例,略低信号1例,其中13例信号不均。动态增强后动脉期均未见明显强化;胰期和门静脉期强化明显,呈等信号5例,略低信号10例,低信号3例;其中5例小胰腺癌4例为等信号,1例为略低信号。在延迟期强化程度下降。9例胰腺内分泌肿瘤(1例未见肿块),在FS-T1WI上低信号5例,略低信号3例;在FS-T2WI上高信号2例,较高信号4例,等信号2例。增强动脉期2例中度强化,6例均未见明显强化;在胰期和门静脉期强化明显,瘤体呈等信号2例,略低信号1例,较高信号5例,6例瘤体周边薄壁环形强化。结论动态MRI增强对两种病变鉴别有一定价值:(1)胰腺癌可有不同程度强化,其最大强化程度不超过正常胰腺组织;(2)胰腺内分泌肿瘤多数可有较明显强化,其最大强化程度可超过正常胰腺组织,瘤体周边薄壁环形高密度强化为本病特征性表现。
Objective To evaluate the diagnostic value of dynamic MR scan in pancreatic and pancreatic endocrine tumors. Methods The MR findings of 22 cases of pancreatic cancer and 9 cases of pancreatic endocrine tumors underwent MR plain scan and dynamic contrast-enhanced scanning before operation were compared. Results In 22 cases of pancreatic cancer (4 cases without mass), there were 11 cases of low signal on FS-T1WI, 6 cases of low signal and 1 case of equal signal on the FS-T1WI. In FS-T2WI, there were 5 cases of high signal and slightly high signal of 7 Cases, and other signals in 5 cases, slightly lower signal in 1 case, of which 13 cases of signal uneven. There was no significant enhancement in the arterial phase after dynamic contrast enhancement. The pancreatic phase and portal vein phase were markedly enhanced. There were 5 cases of equal signal, 10 cases of low signal and 3 cases of low signal. For a slightly lower signal. In the delay period to strengthen the degree of decline. 9 cases of pancreatic endocrine tumors (1 case without mass), FS-T1WI low signal in 5 cases, slightly lower signal in 3 cases; in FS-T2WI high signal in 2 cases, higher signal in 4 cases, and other signals in 2 cases. There were 2 cases of moderate enhancement in arterial phase, 2 cases of moderate enhancement in 6 cases, no obvious enhancement in 6 cases, 2 cases of equal signal in tumor and portal vein, 1 case of slightly lower signal, 5 cases of higher signal and 6 cases of tumor Peripheral thin-walled ring enhanced. Conclusions Dynamic MRI enhancement has certain value in differentiating two kinds of lesions: (1) pancreatic cancer may be enhanced to some extent, and its maximum enhancement degree does not exceed that of normal pancreatic tissue; (2) most of pancreatic endocrine tumors may be significantly strengthened, and their maximum enhancement The degree may exceed the normal pancreatic tissue, the surrounding thin-walled ring-shaped high-density enhanced characteristic manifestation of the disease.