Shinya Satoshi, Sasaki Takamitsu, Nakagawa Yoshifumi, Guiquing Zhang, Yamamoto Fumio, Yamashita Yuichi
Department of Gastroenterological Surgery, Yamamoto Memorial Hospital, 88-4 Hachiyagarami, Nirimachi, Imari, Saga, Japan.
World J Gastroenterol. 2008 Sep 21;14(35):5478-80. doi: 10.3748/wjg.14.5478.
Diffusion-weighted imaging (DWI) is an established diagnostic method of acute stroke. The latest advances in magnetic resonance imaging (MRI) technology have greatly expanded the utility of DWI in the examination of various organs. Recent studies have revealed the usefulness of DWI for imaging of the liver, kidney, ovary, and breast. We report a patient with acute pancreatitis detected by DWI and discussed the efficacy of DWI in diagnosing acute pancreatitis. A 50-year old man presented with a primary complaint of abdominal pain. We performed both DWI and computed tomography (CT) for this patient. The signal intensity in a series of DWI was measured and the apparent diffusion coefficient (ADC) values were calculated to differentiate inflammation from normal tissue. Two experienced radiologists evaluated the grade of acute pancreatitis by comparing the CT findings. Initially, the pancreas and multiple ascites around the pancreas produced a bright signal and ADC values were reduced on DWI. As the inflammation decreased, the bright signal faded to an iso-signal and the ADC values returned to their normal level. There was no difference in the abilities of DWI and CT images to detect acute pancreatitis. However, our case indicates that DWI can evaluate the manifestations of acute pancreatitis using no enhancement material and has the potential to replace CT as a primary diagnostic strategy for acute pancreatitis.
扩散加权成像(DWI)是一种成熟的急性脑卒中诊断方法。磁共振成像(MRI)技术的最新进展极大地扩展了DWI在各种器官检查中的应用。最近的研究揭示了DWI在肝脏、肾脏、卵巢和乳腺成像中的作用。我们报告了一例通过DWI检测出急性胰腺炎的患者,并讨论了DWI在诊断急性胰腺炎中的疗效。一名50岁男性以腹痛为主诉就诊。我们对该患者进行了DWI和计算机断层扫描(CT)检查。测量了一系列DWI中的信号强度,并计算了表观扩散系数(ADC)值,以区分炎症组织与正常组织。两名经验丰富的放射科医生通过比较CT表现评估急性胰腺炎的分级。最初,胰腺及胰腺周围的多处腹水在DWI上产生高信号,ADC值降低。随着炎症减轻,高信号逐渐变为等信号,ADC值恢复至正常水平。DWI和CT图像检测急性胰腺炎的能力没有差异。然而,我们的病例表明,DWI无需使用增强材料即可评估急性胰腺炎的表现,并且有潜力取代CT作为急性胰腺炎的主要诊断策略。