Kim Bohyun, Lee Seung Soo, Sung Yu Sub, Cheong Hyunhee, Byun Jae Ho, Kim Hyoung Jung, Kim Jin Hee
Department of Radiology, Ajou University Hospital, Suwon, South Korea.
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
J Magn Reson Imaging. 2017 Jan;45(1):260-269. doi: 10.1002/jmri.25334. Epub 2016 Jun 7.
To evaluate the diagnostic value of apparent diffusion coefficient (ADC) and intravoxel incoherent motion (IVIM) parameters in differentiating patients with either a normal pancreas (NP), pancreatic ductal adenocarcinoma (PDAC), neuroendocrine tumor (NET), solid pseudopapillary tumor (SPT), acute pancreatitis (AcP), vs. autoimmune pancreatitis (AIP).
In all, 84 pathologically confirmed pancreatic tumors (60 PDACs, 15 NETs, 9 SPTs), 20 pancreatitis (13 AcPs, 7 AIPs), and 30 NP subjects underwent IVIM diffusion-weighted imaging using 10 b-values (0-900 sec/mm ) at 1.5T. The ADC, pure molecular diffusion coefficient (D ), perfusion fraction (f), and perfusion-related diffusion coefficient (D ) were calculated and compared using a Kruskal-Wallis test and post-hoc Dunn procedure. Receiver operating characteristic (ROC) analysis was performed to assess diagnostic performance.
The f and D of the PDAC were significantly lower than that of the NP (f = 0.10 vs. 0.24; D = 42.21 vs. 71.74 × 10 mm /sec; P < 0.05). In ROC analysis, f showed the best diagnostic performance (area-under-the-curve, 0.919) among all parameters in differentiating PDAC from NP (P ≤ 0.001). The f values of AcP (0.11) and AIP (0.13) and the D values of SPT (20.48 × 10 mm /sec) and AcP (24.49 × 10 mm /sec) were significantly lower compared with NP (f = 0.24; D = 71.74 × 10 mm /sec; P < 0.05). For NET, the f (0.21) was significantly higher than that of PDAC (0.10, P < 0.01).
Perfusion-related parameters f and D are more helpful in characterizing pancreatic diseases than ADC or D . The PDCA, SPT, AcP, and AIP were characterized by reduced f and D values compared with normal pancreas. The f value might help in differentiating between PDAC and NET.
3 J. Magn. Reson. Imaging 2017;45:260-269.
评估表观扩散系数（ADC）和体素内不相干运动（IVIM）参数在鉴别正常胰腺（NP）、胰腺导管腺癌（PDAC）、神经内分泌肿瘤（NET）、实性假乳头状肿瘤（SPT）、急性胰腺炎（AcP）与自身免疫性胰腺炎（AIP）患者中的诊断价值。
总共84例经病理证实的胰腺肿瘤（60例PDAC、15例NET、9例SPT）、20例胰腺炎（13例AcP、7例AIP）以及30例NP受试者在1.5T磁场下使用10个b值（0 - 900秒/毫米²）进行IVIM扩散加权成像。计算ADC、纯分子扩散系数（D）、灌注分数（f）和灌注相关扩散系数（D*），并使用Kruskal - Wallis检验和事后Dunn程序进行比较。进行受试者操作特征（ROC）分析以评估诊断性能。
PDAC的f和D显著低于NP（f = 0.10对0.24；D = 42.21对71.74×10⁻³毫米²/秒；P < 0.05）。在ROC分析中，f在区分PDAC与NP的所有参数中表现出最佳诊断性能（曲线下面积，0.919）（P≤0.001）。与NP相比，AcP（0.11）和AIP（0.13）的f值以及SPT（20.48×10⁻³毫米²/秒）和AcP（24.49×10⁻³毫米²/秒）的D值显著降低（f = 0.24；D = 71.74×10⁻³毫米²/秒；P < 0.05）。对于NET，f（0.21）显著高于PDAC（0.10，P < 0.01）。
灌注相关参数f和D在表征胰腺疾病方面比ADC或D更有帮助。与正常胰腺相比，PDCA、SPT、AcP和AIP的特征是f和D值降低。f值可能有助于区分PDAC和NET。
3 J.Magn.Reson.Imaging 2017;45:260 - 269。
