Hirose Y
1st Department of Surgery, Faculty of Medicine, Kyoto University, Japan.
Nihon Geka Hokan. 1991 Sep 1;60(5):316-26.
Diagnostic ability of Magnetic Resonance Imaging (MRI) was evaluated in 41 patients with pancreatic cancer who underwent surgery 1 to 43 days following MRI. MRI of surgical specimens revealed that pancreatic cancer and caudal pancreatitis showed similar intensities when compared with the normal pancreas. The usefulness of the contrast medium, Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA), was confirmed in the differentiation between cancer and caudal pancreatitis. In the diagnosis of tumor extension, portal vein invasion was better diagnosed by MRI than by angiography. (Spearman's rank correlation test showed higher correlation in MRI than in angiography, p = 0.501, 0.464, respectively.) In the diagnosis of the invasion to the anterior pancreatic capsule its sensitivity was 43%, specificity 81% and efficiency 59%. Retropancreatic invasion was diagnosed with a sensitivity of 48%, a specificity of 90% and an efficiency of 59%. Lymph-node metastasis was well demonstrated especially near the pancreas but beyond them it was difficult. The liver metastasis was correctly diagnosed in 7 of 9 cases and was confirmed by laparotomy.
对41例胰腺癌患者进行了磁共振成像（MRI）诊断能力评估，这些患者在MRI检查后1至43天接受了手术。手术标本的MRI显示，与正常胰腺相比，胰腺癌和尾部胰腺炎的信号强度相似。证实了造影剂钆喷酸葡胺（Gd-DTPA）在鉴别癌症和尾部胰腺炎方面的有效性。在肿瘤侵犯范围的诊断中，MRI对门静脉侵犯的诊断优于血管造影。（Spearman等级相关检验显示，MRI的相关性高于血管造影，p值分别为0.501和0.464。）在诊断胰腺前包膜侵犯时，其敏感性为43%，特异性为81%，准确性为59%。诊断胰后侵犯的敏感性为48%，特异性为90%，准确性为59%。淋巴结转移在胰腺附近显示良好，但在胰腺以外则难以显示。9例中有7例肝转移被正确诊断，并经剖腹手术证实。
