Lu Guang-ming, Wang Zhong-qiu, Zheng Ling, Wang Jun-peng, Qiu Xiao-ming, Tang Xiao-jun
Department of Medical Imaging, Jinling Hospital, Nanjing 210002, China.
Zhonghua Yi Xue Za Zhi. 2006 Apr 11;86(14):951-4.
To explore the value of dynamic enhanced magnetic resonance (MR) in diagnosis of pancreatic carcinoma and endocrine tumors.
Twenty-two patients with pancreatic carcinoma and 9 patients with pancreatic endocrine tumors underwent routine MR scanning and dynamic contrast enhanced MR examination before they underwent operation.
No tumor image was seen in 4 of the 22 patients with pancreatic carcinoma by routine MR scanning. Fat-saturated T(1)-weighted imaging (FS-T(1) WI) showed that 11 of them were hyposignal, 6 slightly hyposignal, and 1 isosignal; and fat-saturated T(2)-weighted imaging (FS-T(2) WI) showed that 5 were hypersignal, 7 slightly hypersignal, 5 isosignal, 1 slightly hyposignal, and 13 with heterogeneous signals. After dynamic MR imaging no tumor was enhanced in the arterial phase (AP); and all the tumors were obviously enhanced during the pancreatic phase (PP) and portal venous phase (PVP), 5 of which showed isosignal intensity, 10 slightly hyposignal intensity, and 3 hyposignal intensity. Four of the 5 cases with small pancreatic carcinoma were demonstrated as isosignal and one was slightly hyposignal. During the delayed enhancement phase (DEP) the signal intensity of the tumors became slightly weaker. No tumor image was seen in 14 of the 9 patients with pancreatic endocrine tumors by routine MR scanning. FS-T(1) WI showed that 5 of them were hyposignal, and 3 slightly hyposignal; and FS-T(2) WI showed that 2 were hypersignal, 4 slightly hyposignal, and 2 isosignal. After dynamic MR imaging 2 cases were moderately enhanced and 6 cases mildly enhanced during AP, and all pancreatic endocrine tumors were obviously enhanced during PP and PVP, with isosignal intensity in 2 cases, slightly hyposignal intensity in 1 case, and slightly hypersignal intensity in 5 cases. Peritumor thin-walled enhancement was seen in 6 cases.
Dynamic enhanced MR has a certain value in the diagnosis of pancreatic carcinoma and endocrine tumors. Pancreatic carcinoma shows various enhanced forms by dynamic enhanced magnetic resonance, the degree of the greatest enhanced form not surpassing that of normal pancreatic tissue. Pancreatic endocrine carcinoma shows obvious enhanced forms by dynamic enhanced magnetic resonance, the degree of the greatest enhanced form surpassing that of normal pancreatic tissue. Peritumor thin-walled enhancement is a characteristic feature of pancreatic endocrine carcinoma.
探讨动态增强磁共振成像（MR）在胰腺癌及内分泌肿瘤诊断中的价值。
22例胰腺癌患者和9例胰腺内分泌肿瘤患者在手术前行常规MR扫描及动态对比增强MR检查。
22例胰腺癌患者中，4例常规MR扫描未见肿瘤影像。脂肪饱和T1加权成像（FS-T1WI）显示，其中11例呈低信号，6例呈稍低信号，1例呈等信号；脂肪饱和T2加权成像（FS-T2WI）显示，5例呈高信号，7例呈稍高信号，5例呈等信号，1例呈稍低信号，13例信号不均匀。动态MR成像显示，动脉期（AP）无肿瘤强化；胰腺期（PP）和门静脉期（PVP）所有肿瘤均明显强化，其中5例呈等信号强度，10例呈稍低信号强度，3例呈低信号强度。5例小胰腺癌中4例呈等信号，1例呈稍低信号。延迟强化期（DEP）肿瘤信号强度稍减弱。9例胰腺内分泌肿瘤患者中，14例常规MR扫描未见肿瘤影像。FS-T1WI显示，其中5例呈低信号，3例呈稍低信号；FS-T2WI显示，2例呈高信号，4例呈稍低信号，2例呈等信号。动态MR成像显示，AP期2例中等强化，6例轻度强化，PP期和PVP期所有胰腺内分泌肿瘤均明显强化，其中2例呈等信号强度，1例呈稍低信号强度，5例呈稍高信号强度。6例可见肿瘤周围薄壁强化。
动态增强MR在胰腺癌及内分泌肿瘤诊断中有一定价值。胰腺癌动态增强磁共振表现为多种强化形式，最大强化程度不超过正常胰腺组织。胰腺内分泌癌动态增强磁共振表现为明显强化形式，最大强化程度超过正常胰腺组织。肿瘤周围薄壁强化是胰腺内分泌癌的特征性表现。
