• 四川大學(xué)華西醫(yī)院放射科(成都610041);

目的  總結(jié)各種磁共振(MR)功能成像的原理及在胰腺癌及腫塊型慢性胰腺炎診斷中的應(yīng)用價(jià)值。
方法  回顧分析國(guó)內(nèi)、外近年來(lái)關(guān)于MR波譜成像、MR彌散成像及MR灌注成像在胰腺癌及慢性胰腺炎診斷和鑒別診斷中應(yīng)用的文獻(xiàn)。
結(jié)果  胰腺癌與慢性胰腺炎在分子擴(kuò)散、生化代謝、組織灌注等方面存在差異,MR功能成像方法能反映這些差異而用于鑒別診斷。
結(jié)論  MR功能成像作為一種非侵入性的影像檢查方法,能夠提供鑒別胰腺癌與腫塊型慢性胰腺炎有價(jià)值的信息。

引用本文: 陳錦秀,宋彬,吳苾. 磁共振功能成像鑒別胰腺癌與腫塊型慢性胰腺炎的價(jià)值. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007, 14(6): 722-725. doi: 復(fù)制

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2.  葛春林, 郭克建. 胰腺癌可切除性的判斷 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2003; 10(6)∶526.
3.  Niederau C, Grendell JH. Diagnosis of pancreatic carcinoma. Imaging techniques and tumor markers [J]. Pancreas, 1992; 7(1)∶66.
4.  Gudjonsson B, Livstone EM, Spiro HM. Cancer of the pancreas: diagnostic accuracy and survival statistics [J]. Cancer, 1978; 42(5)∶2494.
5.  宋彬, 閔鵬秋, 吳苾, 等. 磁共振VIBE序列鑒別胰腺癌與腫塊型慢性胰腺炎的價(jià)值探討 [J]. 放射學(xué)實(shí)踐, 2006; 21(51)∶498.
6.  Henriksen O. MR spectroscopy in clinical research [J]. Acta Radiol, 1994; 35(2)∶96.
7.  Cho SG, Lee DH, Lee KY, et al. Differentiation of chronic focal pancreatitis from pancreatic carcinoma by in vivo proton magnetic resonance spectroscopy [J]. J Comput Assist Tomogr, 2005; 29(2)∶163.
8.  Kim T, Murakami T, Takamura M, et al. Pancreatic mass due to chronic pancreatitis: correlation of CT and MR imaging features with pathologic findings [J]. AJR Am J Roentgenol, 2001; 177(2)∶367.
9.  Cho SG, Kim YS, Kim HJ, et al. Chronic hepatitis: in vivo proton MR spectroscopic evaluation of the liver and correlation with histopathologic findings [J]. Radiology, 2001; 221(3)∶740.
10.  Kaplan O, Kushnir T, Askenazy N, et al. Role of nuclear magnetic resonance spectroscopy (MRS) in cancer diagnosis and treatment: 31P, 23Na, and 1H MRS studies of three models of pancreatic cancer [J]. Cancer Res, 1997; 57(8)∶1452.
11.  Wright CE, Tallan HH, Lin YY, et al. Taurine: biological update [J]. Annu Rev Biochem, 1986; 55∶427.
12.  Moreno A, Rey M, Montane JM, et al. 1H NMR spectroscopy of colon tumors and normal mucosal biopsies; elevated taurine levels and reduced polyethyleneglycol absorption in tumors may have diagnostic significance [J]. NMR Biomed, 1993; 6(2)∶111.
13.  Remy C, Arus C, Ziegler A, et al. In vivo, ex vivo, and in vitro one- and two-dimensional nuclear magnetic resonance spectroscopy of an intracerebral glioma in rat brain: assignment of resonances [J]. J Neurochem, 1994; 62(1)∶166.
14.  Chemin-Thomas C, Palévody C, Esclassan J, et al. Combined magnetic resonance imaging and spectrometry for characterization of human pancreatic adenocarcinoma (Capan-1) heterotransplanted in nude mice [J]. Gastroenterol Clin Biol, 1994; 18(10)∶859.
15.  Khan SA, Cox IJ, Thillainayagam AV, et al. Proton and phosphorus-31 nuclear magnetic resonance spectroscopy of human bile in hepatopancreaticobiliary cancer [J]. Eur J Gastroenterol Hepatol, 2005; 17(7)∶733.
16.  Pierpaoli C, Righini A, Linfante I, et al. Histopathologic correlates of abnormal water diffusion in cerebral ischemia: diffusion-weighted MR imaging and light and electron microscopic study [J]. Radiology, 1993; 189(2)∶439.
17.  邢悅, 劉榮波. 肝臟磁共振彌散加權(quán)成像的研究進(jìn)展 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007; 14(3)∶359.
18.  楊洋, 宋彬, 吳苾. 慢性病毒性肝炎組織病理學(xué)分級(jí)和磁共振彌散成像的對(duì)照研究 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2006; 13(4)∶469.
19.  Roth Y, Tichler T, Kostenich G, et al. High-b-value diffusion-weighted MR imaging for pretreatment prediction and early monitoring of tumor response to therapy in mice [J]. Radiology, 2004; 232(3)∶685.
20.  Lyng H, Haraldseth O, Rofstad EK. Measurement of cell density and necrotic fraction in human melanoma xenografts by diffusion weighted magnetic resonance imaging [J]. Magn Reson Med, 2000; 43(6)∶828.
21.  Yoshikawa T, Kawamitsu H, Mitchell DG, et al. ADC measurement of abdominal organs and lesions using parallel imaging technique [J]. AJR Am J Roentgenol, 2006; 187(6)∶1521.
22.  Taouli B, Vilgrain V, Dumont E, et al. Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences: prospective study in 66 patients [J]. Radiology, 2003; 226(1)∶71.
23.  Sinha S, Lucas-Quesada FA, Sinha U, et al. In vivo diffusion-weighted MRI of the breast: potential for lesion characterization [J]. J Magn Reson Imaging, 2002; 15(6)∶693.
24.  Katayama M, Masui T, Kobayashi S, et al. Diffusion-weighted echo planar imaging of ovarian tumors: is it useful to measure apparent diffusion coefficients? [J]. J Comput Assist Tomogr, 2002; 26(2)∶250.
25.  任瑩, 金征宇, 馮逢, 等. 3.0T磁共振擴(kuò)散加權(quán)成像對(duì)胰腺癌的診斷價(jià)值初探 [J]. 中國(guó)醫(yī)學(xué)影像技術(shù), 2006; 22(4) ∶581.
26.  Ichikawa T, Haradome H, Hachiya J, et al. Diffusion-weighted MR imaging with single-shot echo-planar imaging in the upper abdomen: preliminary clinical experience in 61 patients [J]. Abdom Imaging, 1999; 24(5)∶456.
27.  Ichikawa T, Erturk SM, Motosugi U, et al. High-b value diffusion-weighted MRI for detecting pancreatic adenocarcinoma: preliminary results [J]. AJR Am J Roentgenol, 2007; 188(2)∶409.
28.  Hosten N, Lemke AJ, Wiedenmann B, et al. Combined imaging techniques for pancreatic cancer [J]. Lancet, 2000; 356(9233)∶909.
29.  Tajima Y, Kuroki T, Tsutsumi R, et al. Pancreatic carcinoma coexisting with chronic pancreatitis versus tumor-forming pancreatitis: diagnostic utility of the time-signal intensity curve from dynamic contrast-enhanced MR imaging [J]. World J Gastroenterol, 2007; 13(6)∶858.
30.  吳苾, 宋彬. 影像學(xué)新技術(shù)在消化系統(tǒng)的臨床應(yīng)用 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007; 14(2)∶222.
  1. 1.  Steer ML, Waxman I, Freedman S. Chronic pancreatitis [J]. N Engl J Med, 1995; 332(22)∶1482.
  2. 2.  葛春林, 郭克建. 胰腺癌可切除性的判斷 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2003; 10(6)∶526.
  3. 3.  Niederau C, Grendell JH. Diagnosis of pancreatic carcinoma. Imaging techniques and tumor markers [J]. Pancreas, 1992; 7(1)∶66.
  4. 4.  Gudjonsson B, Livstone EM, Spiro HM. Cancer of the pancreas: diagnostic accuracy and survival statistics [J]. Cancer, 1978; 42(5)∶2494.
  5. 5.  宋彬, 閔鵬秋, 吳苾, 等. 磁共振VIBE序列鑒別胰腺癌與腫塊型慢性胰腺炎的價(jià)值探討 [J]. 放射學(xué)實(shí)踐, 2006; 21(51)∶498.
  6. 6.  Henriksen O. MR spectroscopy in clinical research [J]. Acta Radiol, 1994; 35(2)∶96.
  7. 7.  Cho SG, Lee DH, Lee KY, et al. Differentiation of chronic focal pancreatitis from pancreatic carcinoma by in vivo proton magnetic resonance spectroscopy [J]. J Comput Assist Tomogr, 2005; 29(2)∶163.
  8. 8.  Kim T, Murakami T, Takamura M, et al. Pancreatic mass due to chronic pancreatitis: correlation of CT and MR imaging features with pathologic findings [J]. AJR Am J Roentgenol, 2001; 177(2)∶367.
  9. 9.  Cho SG, Kim YS, Kim HJ, et al. Chronic hepatitis: in vivo proton MR spectroscopic evaluation of the liver and correlation with histopathologic findings [J]. Radiology, 2001; 221(3)∶740.
  10. 10.  Kaplan O, Kushnir T, Askenazy N, et al. Role of nuclear magnetic resonance spectroscopy (MRS) in cancer diagnosis and treatment: 31P, 23Na, and 1H MRS studies of three models of pancreatic cancer [J]. Cancer Res, 1997; 57(8)∶1452.
  11. 11.  Wright CE, Tallan HH, Lin YY, et al. Taurine: biological update [J]. Annu Rev Biochem, 1986; 55∶427.
  12. 12.  Moreno A, Rey M, Montane JM, et al. 1H NMR spectroscopy of colon tumors and normal mucosal biopsies; elevated taurine levels and reduced polyethyleneglycol absorption in tumors may have diagnostic significance [J]. NMR Biomed, 1993; 6(2)∶111.
  13. 13.  Remy C, Arus C, Ziegler A, et al. In vivo, ex vivo, and in vitro one- and two-dimensional nuclear magnetic resonance spectroscopy of an intracerebral glioma in rat brain: assignment of resonances [J]. J Neurochem, 1994; 62(1)∶166.
  14. 14.  Chemin-Thomas C, Palévody C, Esclassan J, et al. Combined magnetic resonance imaging and spectrometry for characterization of human pancreatic adenocarcinoma (Capan-1) heterotransplanted in nude mice [J]. Gastroenterol Clin Biol, 1994; 18(10)∶859.
  15. 15.  Khan SA, Cox IJ, Thillainayagam AV, et al. Proton and phosphorus-31 nuclear magnetic resonance spectroscopy of human bile in hepatopancreaticobiliary cancer [J]. Eur J Gastroenterol Hepatol, 2005; 17(7)∶733.
  16. 16.  Pierpaoli C, Righini A, Linfante I, et al. Histopathologic correlates of abnormal water diffusion in cerebral ischemia: diffusion-weighted MR imaging and light and electron microscopic study [J]. Radiology, 1993; 189(2)∶439.
  17. 17.  邢悅, 劉榮波. 肝臟磁共振彌散加權(quán)成像的研究進(jìn)展 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007; 14(3)∶359.
  18. 18.  楊洋, 宋彬, 吳苾. 慢性病毒性肝炎組織病理學(xué)分級(jí)和磁共振彌散成像的對(duì)照研究 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2006; 13(4)∶469.
  19. 19.  Roth Y, Tichler T, Kostenich G, et al. High-b-value diffusion-weighted MR imaging for pretreatment prediction and early monitoring of tumor response to therapy in mice [J]. Radiology, 2004; 232(3)∶685.
  20. 20.  Lyng H, Haraldseth O, Rofstad EK. Measurement of cell density and necrotic fraction in human melanoma xenografts by diffusion weighted magnetic resonance imaging [J]. Magn Reson Med, 2000; 43(6)∶828.
  21. 21.  Yoshikawa T, Kawamitsu H, Mitchell DG, et al. ADC measurement of abdominal organs and lesions using parallel imaging technique [J]. AJR Am J Roentgenol, 2006; 187(6)∶1521.
  22. 22.  Taouli B, Vilgrain V, Dumont E, et al. Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences: prospective study in 66 patients [J]. Radiology, 2003; 226(1)∶71.
  23. 23.  Sinha S, Lucas-Quesada FA, Sinha U, et al. In vivo diffusion-weighted MRI of the breast: potential for lesion characterization [J]. J Magn Reson Imaging, 2002; 15(6)∶693.
  24. 24.  Katayama M, Masui T, Kobayashi S, et al. Diffusion-weighted echo planar imaging of ovarian tumors: is it useful to measure apparent diffusion coefficients? [J]. J Comput Assist Tomogr, 2002; 26(2)∶250.
  25. 25.  任瑩, 金征宇, 馮逢, 等. 3.0T磁共振擴(kuò)散加權(quán)成像對(duì)胰腺癌的診斷價(jià)值初探 [J]. 中國(guó)醫(yī)學(xué)影像技術(shù), 2006; 22(4) ∶581.
  26. 26.  Ichikawa T, Haradome H, Hachiya J, et al. Diffusion-weighted MR imaging with single-shot echo-planar imaging in the upper abdomen: preliminary clinical experience in 61 patients [J]. Abdom Imaging, 1999; 24(5)∶456.
  27. 27.  Ichikawa T, Erturk SM, Motosugi U, et al. High-b value diffusion-weighted MRI for detecting pancreatic adenocarcinoma: preliminary results [J]. AJR Am J Roentgenol, 2007; 188(2)∶409.
  28. 28.  Hosten N, Lemke AJ, Wiedenmann B, et al. Combined imaging techniques for pancreatic cancer [J]. Lancet, 2000; 356(9233)∶909.
  29. 29.  Tajima Y, Kuroki T, Tsutsumi R, et al. Pancreatic carcinoma coexisting with chronic pancreatitis versus tumor-forming pancreatitis: diagnostic utility of the time-signal intensity curve from dynamic contrast-enhanced MR imaging [J]. World J Gastroenterol, 2007; 13(6)∶858.
  30. 30.  吳苾, 宋彬. 影像學(xué)新技術(shù)在消化系統(tǒng)的臨床應(yīng)用 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007; 14(2)∶222.