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, 848-0031, Japan.
Hepatogastroenterology. 2009 Sep-Oct;56(94-95):1407-10.
BACKGROUND/AIMS: Diffusion-weighted imaging (DWI) is a new magnetic resonance imaging (MRI) technique that evaluates the random motion of water molecules in biological tissues. The clinical utility of DWI has been established for acute stroke and brain tumors. Recent technical advancements in MRI have enabled DWI for the body and several studies have revealed the efficacy of DWI for detecting various diseases. This study documents the efficacy of DWI for the evaluation of acute pancreatitis.
MRI was performed with sequences including T1-weighted, T2-weighted, diffusion-weighted imaging, MR cholangiopancreatography (MRCP) and computed tomography (CT) examinations on 11 patients with mild acute pancreatitis. MRI examinations were performed using 1.5-T imager (Toshiba, Otawara, Japan). Two experienced radiologists evaluated the presence or absence of acute pancreatitis, complications and the cause of acute pancreatitis on the MRI and CT images.
There were no differences between the DWI and the CT images regarding their abilities to detect acute pancreatitis. However, DWI could detect acute pancreatitis more clearly than CT without enhancing material. The DWI findings were consistent with the clinical findings, the results of chemical analyses and the CT findings. Furthermore, DWI could detect pancreatic cancer causing acute pancreatitis and MR cholangiopancreatography (MRCP) could detect choledocholithiasis and pancreas divisum causing acute pancreatitis.
DWI can be a powerful tool for the evaluation and follow-up of acute pancreatitis.
背景/目的：扩散加权成像（DWI）是一种新的磁共振成像（MRI）技术，用于评估生物组织中水分子的随机运动。DWI在急性脑卒中及脑肿瘤方面的临床应用已得到确立。MRI技术的最新进展使得DWI能够用于身体检查，多项研究已揭示DWI在检测各种疾病方面的有效性。本研究记录了DWI在评估急性胰腺炎方面的有效性。
对11例轻度急性胰腺炎患者进行了MRI检查，检查序列包括T1加权、T2加权、扩散加权成像、磁共振胰胆管造影（MRCP）及计算机断层扫描（CT）。MRI检查使用1.5-T成像仪（日本大田原东芝公司）。两名经验丰富的放射科医生在MRI和CT图像上评估急性胰腺炎的有无、并发症及急性胰腺炎的病因。
在检测急性胰腺炎的能力方面，DWI图像与CT图像之间没有差异。然而，在不使用增强剂的情况下，DWI比CT能更清晰地检测出急性胰腺炎。DWI表现与临床发现、化学分析结果及CT表现一致。此外，DWI能够检测出导致急性胰腺炎的胰腺癌，而磁共振胰胆管造影（MRCP）能够检测出导致急性胰腺炎的胆总管结石及胰腺分裂症。
DWI可成为评估及随访急性胰腺炎的有力工具。
