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磁共振成像预测胰腺癌手术后复发的价值。

MR imaging for predicting the recurrence of pancreatic carcinoma after surgical resection.

机构信息

Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.

出版信息

Eur J Radiol. 2010 Mar;73(3):572-8. doi: 10.1016/j.ejrad.2008.12.007. Epub 2009 Jan 18.

Abstract

OBJECTIVE

To study the relationship of characteristics of pancreatic carcinoma on MR imaging to tumor recurrence time after surgical resection.

MATERIALS AND METHODS

Twenty-seven patients with pancreatic carcinoma were followed up at least 2 years after surgical resection of the tumor. All patients had MR imaging within 1 month before surgery. The tumor's size, signal intensity, local and vascular invasion, abdominal lymphadenopathy on MR imaging and the positive surgical margin were noted. The results from MR imaging were compared with the duration after surgery until tumor recurrence and with the positive surgical margin.

RESULTS

59% of patients had various degree of extrapancreatic invasion. The tumor recurrence times were, respectively, 24+/-21 months and 26+/-29 months in patients with and without vascular invasion (P=0.79). The combination of vascular with local invasion showed a correlation to the time of tumor recurrence (r=-0.34; P<0.05). Patients with positive surgical margins had a higher local invasion score on MR imaging and a shorter recurrence time than those with negative surgical margins. The number and size of lymph nodes were not related with tumor recurrence time.

CONCLUSION

MR imaging was useful for predicting the recurrence of pancreatic carcinoma after surgical resection. Local invasion associated with and without vascular invasion on MR imaging was the indicator for the tumor recurrence.

摘要

目的

研究胰腺癌在磁共振成像(MRI)上的特征与手术后肿瘤复发时间的关系。

材料与方法

对 27 例手术后至少随访 2 年的胰腺癌患者进行研究。所有患者在手术前 1 个月内均进行了 MRI 检查。记录肿瘤的大小、信号强度、局部和血管侵犯、MR 成像上的腹部淋巴结肿大以及阳性手术切缘等情况。将 MRI 结果与术后肿瘤复发时间以及阳性手术切缘进行比较。

结果

59%的患者有不同程度的胰外侵犯。有血管侵犯和无血管侵犯的患者肿瘤复发时间分别为 24+/-21 个月和 26+/-29 个月(P=0.79)。血管侵犯与局部侵犯的组合与肿瘤复发时间呈负相关(r=-0.34;P<0.05)。阳性手术切缘患者的 MRI 局部侵犯评分较高,复发时间较短,而阴性手术切缘患者则相反。淋巴结的数量和大小与肿瘤复发时间无关。

结论

MRI 对预测胰腺癌手术后的复发具有一定的价值。MR 成像上的局部侵犯伴或不伴血管侵犯是肿瘤复发的指标。

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