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[使用锰-二吡啶二羧酸钆进行胰腺病变的磁共振成像。组织病理学相关性]

[MR imaging of pancreatic lesions with Mn-DPDP. A histopathologic correlation].

作者信息

Dobritz M, Fellner F A, Baum U, Nömayr A, Lell M, Klein P, Papadopoulos T, Bautz W

机构信息

Institut für Diagnostische Radiologie, Friedrich-Alexander Universität Erlangen, Nürnberg, Germany.

出版信息

Rofo. 2002 Jul;174(7):893-7. doi: 10.1055/s-2002-32694.

Abstract

PURPOSE

To examine the diagnostic accuracy of pancreatic lesions using mangafodipir-trisodium (Mn-DPDP) enhanced MR imaging. The imaging results were correlated with the histopathological results.

MATERIAL AND METHODS

40 patients with suspicion of pancreatic carcinoma were examined with MRI before and after i. v. administration of Mn-DPDP (Philips Gyroscan ACS NT 1.5 T, phased array body-coil: TSE T 2 with and without SPIR, TR 2000 ms, TE 120ms; FFE T 1 breathhold, TR 115 ms, TE 4.6 ms; MRCP, TR 6000 ms, TE 1200 ms; Teslascan i. v. 5 micromol Mn/kg; FFE T 1 breathhold SPIR, TR 140 ms, TE 4,6 ms). Two observers evaluated in consensus the number and characteristics of focal pancreatic lesions. The MR findings were correlated with histopathological findings retrospectively.

RESULTS

The following lesions were found: adenocarcinoma (19), pancreatitis (8), adenocarcinoma within pancreatitis (3), insulinoma (2), hematoma (1), papillitis stenosans (1), signet ring cell carcinoma (1), metastasis of rectal carcinoma (1), papillary mesothelioma (1). In three patients there was no pathological finding. Mn-DPDP enhanced MRI showed a sensitivity of 100 % and a specificity of 56 %.

CONCLUSION

Mn-DPDP enhanced MRI in conjunction with MRCP showed a high sensitivity for the detection of pancreatic lesions. However, the specificity is low, thus recommending Mn-DPDP enhanced MRI only as a complementary imaging method.

摘要

目的

探讨锰福地匹三钠(Mn-DPDP)增强磁共振成像对胰腺病变的诊断准确性,并将成像结果与组织病理学结果进行对比。

材料与方法

40例疑似胰腺癌患者在静脉注射Mn-DPDP前后接受MRI检查(飞利浦Gyroscan ACS NT 1.5 T,相控阵体线圈:有和没有频谱预饱和反转恢复(SPIR)的快速自旋回波(TSE)T2序列,重复时间(TR)2000 ms,回波时间(TE)120 ms;快速场回波(FFE)T1屏气序列,TR 115 ms,TE 4.6 ms;磁共振胰胆管造影(MRCP),TR 6000 ms,TE 1200 ms;静脉注射5 μmol Mn/kg的Teslascan;FFE T1屏气SPIR序列,TR 140 ms,TE 4.6 ms)。两名观察者共同评估胰腺局灶性病变的数量和特征。将磁共振成像(MR)结果与组织病理学结果进行回顾性对比。

结果

发现以下病变:腺癌(19例)、胰腺炎(8例)、胰腺炎合并腺癌(3例)、胰岛素瘤(2例)、血肿(1例)、狭窄性乳头炎(1例)、印戒细胞癌(1例)、直肠癌转移(1例)、乳头状间皮瘤(1例)。3例患者未发现病理改变。Mn-DPDP增强MRI显示敏感性为100%,特异性为56%。

结论

Mn-DPDP增强MRI联合MRCP对胰腺病变的检测具有较高的敏感性。然而,其特异性较低,因此仅推荐将Mn-DPDP增强MRI作为一种补充性成像方法。

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