Ma Xiaohong, Zhao Xinming, Ouyang Han, Sun Fei, Zhang Hongmei, Zhou Chunwu
Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China.
Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
Acta Radiol. 2014 Sep;55(7):785-92. doi: 10.1177/0284185113509264. Epub 2013 Oct 28.
As their prognosis and management are different, differentiation of mass-forming focal pancreatitis (FP) from pancreatic adenocarcinoma (PC) is important. However, the similar clinical presentations and imaging features of these conditions, along with inconclusive biopsy results can make such differentiation difficult.
To determine whether apparent diffusion coefficient (ADC) histogram analysis can discriminate between a normal pancreas, FP, and PC.
In a retrospective study, 25 PC patients, 14 FP patients, and 25 subjects with a normal pancreas underwent breath-hold diffusion-weighted imaging (DWI) on a 3.0 T magnetic resonance (MR) scanner. Regions of interest (ROIs) were drawn on the normal pancreases and on the entire focal lesions of both PC and FP. The ADC value was averaged from the lowest to 10th, 30th, 50th, and 100th percentile of the histogram (i.e. ADC10, ADC30, ADC50, and ADC100, respectively), and the results were analyzed statistically.
There were no significant differences among the head, body, and tail of normal pancreases for any of the mean ADC values (P > 0.05). ADC10, ADC30, and ADC50 values demonstrated significant differences between lesion and non-lesion areas of both PC (P < 0.05) and FP (P < 0.05). Differences in lesion areas between PC and FP were found with ADC50 and ADC100 values (P < 0.05), and helped differentiate a normal pancreas from FP and PC, and FP from PC.
Quantified ADC histogram can specifically reflect tissue heterogeneity and help differentiate a normal pancreas from FP and PC.
由于肿块型局灶性胰腺炎（FP）和胰腺腺癌（PC）的预后及治疗方法不同，因此区分二者很重要。然而，这两种疾病相似的临床表现和影像学特征，以及活检结果的不确定性，使得这种区分变得困难。
确定表观扩散系数（ADC）直方图分析能否区分正常胰腺、FP和PC。
在一项回顾性研究中，25例PC患者、14例FP患者和25例胰腺正常的受试者在3.0T磁共振（MR）扫描仪上进行了屏气扩散加权成像（DWI）。在正常胰腺以及PC和FP的整个局灶性病变上绘制感兴趣区（ROI）。从直方图的最低到第10、30、50和100百分位数计算ADC值的平均值（即分别为ADC10、ADC30、ADC50和ADC100），并对结果进行统计学分析。
正常胰腺的头部、体部和尾部之间的任何平均ADC值均无显著差异（P>0.05）。PC（P<0.05）和FP（P<0.05）的病变区和非病变区之间，ADC10、ADC30和ADC50值均显示出显著差异。PC和FP的病变区在ADC50和ADC100值上存在差异（P<0.05），有助于区分正常胰腺与FP和PC，以及FP与PC。
量化的ADC直方图可以特异性地反映组织异质性，有助于区分正常胰腺与FP和PC。
