是否有必要进行磁共振胰胆管成像（MRCP）来诊断胰腺分裂症？

Is MRCP necessary to diagnose pancreas divisum?

机构信息

Department of MRI, Research Institute of Clinical Medicine (Todua Clinic), 13 Tevdore mgvdlis St., 0112, Tbilisi, Georgia.

Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, INF 110, 69120, Heidelberg, Germany.

出版信息

BMC Med Imaging. 2019 Apr 29;19(1):33. doi: 10.1186/s12880-019-0329-1.

DOI:10.1186/s12880-019-0329-1

PMID:31035952

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6489286/

Abstract

BACKGROUND

The purpose of this study is to compare the performance of three-dimensional magnetic resonance cholangiopancreatography (3D-MRCP) with non-MRCP T2-weighted magnetic resonance imaging (MRI) sequences for diagnosis of pancreas divisum (PD).

METHODS

This is a retrospective study of 342 consecutive patients with abdominal MRI including 3D-MRCP. 3D-MRCP was a coronal respiration-navigated T2-weighted sequence with 1.5 mm slice thickness. Non-MRCP T2-weighted sequences were (1) a coronal inversion recovery sequence (TIRM) with 6 mm slice thickness and (2) a transverse single shot turbo spin echo sequence (HASTE) with 4 mm slice thickness. For 3D-MRCP, TIRM, and HASTE, presence of PD and assessment of evaluability were determined in a randomized manner. A consensus read by two radiologists using 3D-MRCP, non-MRCP T2-weighted sequences, and other available imaging sequences served as reference standard for diagnosis of PD. Statistical analysis included performance analysis of 3D-MRCP, TIRM, and HASTE and testing for noninferiority of non-MRCP T2-weighted sequences compared with 3D-MRCP.

RESULTS

Thirty-three of 342 patients (9.7%) were diagnosed with PD using the reference standard. Sensitivity/specificity of 3D-MRCP for detecting PD were 81.2%/69.7% (p < 0.001). Sensitivity/specificity of TIRM and HASTE were 92.5%/93.9 and 98.1%/97.0%, respectively (p < 0.001 each). Grouped sensitivity/specificity of non-MRCP T2-weighted sequences were 99.8%/91.0%. Non-MRCP T2-weighted sequences were non-inferior to 3D-MRCP alone for diagnosis of PD. 20.2, 7.3%, and 2.3% of 3D-MRCP, TIRM, and HASTE, respectively, were not evaluable due to motion artifacts or insufficient duct depiction.

CONCLUSIONS

Non-MRCP T2-weighted MRI sequences offer high performance for diagnosis of PD and are noninferior to 3D-MRCP alone.

TRIAL REGISTRATION

Not applicable.

摘要

背景

本研究旨在比较三维磁共振胰胆管成像（3D-MRCP）与非 MRCP T2 加权磁共振成像（MRI）序列在胰腺分裂症（PD）诊断中的性能。

方法

这是一项回顾性研究，纳入了 342 例接受腹部 MRI 检查的连续患者，其中包括 3D-MRCP。3D-MRCP 采用冠状呼吸导航 T2 加权序列，层厚为 1.5mm。非 MRCP T2 加权序列包括（1）冠状反转恢复序列（TIRM），层厚 6mm；（2）横轴面单次激发快速自旋回波序列（HASTE），层厚 4mm。对于 3D-MRCP、TIRM 和 HASTE，以随机方式确定 PD 的存在和评估的可评估性。两名放射科医生使用 3D-MRCP、非 MRCP T2 加权序列和其他可用成像序列进行共识读片，作为 PD 诊断的参考标准。统计分析包括 3D-MRCP、TIRM 和 HASTE 的性能分析，以及非 MRCP T2 加权序列与 3D-MRCP 相比的非劣效性检验。

结果

342 例患者中，33 例（9.7%）经参考标准诊断为 PD。3D-MRCP 检测 PD 的敏感性/特异性分别为 81.2%/69.7%（p<0.001）。TIRM 和 HASTE 的敏感性/特异性分别为 92.5%/93.9%和 98.1%/97.0%（p<0.001）。非 MRCP T2 加权序列的分组敏感性/特异性分别为 99.8%/91.0%。非 MRCP T2 加权序列在 PD 诊断方面不劣于单独的 3D-MRCP。由于运动伪影或胰管显示不足，3D-MRCP、TIRM 和 HASTE 分别有 20.2%、7.3%和 2.3%的序列无法评估。