Arora Manali, Lakhera Devkant, Rawat Kanica, Thakker Vishal, Randhawa Lovepreet Singh, Patel Amisha, Agarwal Rachit, Azad Rajiv Kumar
Department of Radiology, SGRRIM and HS, Dehradun, Uttarakhand, India.
Ann Afr Med. 2024 Oct 1;23(4):635-640. doi: 10.4103/aam.aam_79_24. Epub 2024 Aug 13.
Diffusion-weighted imaging (DWI) has come up as a newer diagnostic modality for the diagnosis of early functional changes in various organs including the pancreas. DWI has shown the ability of early and accurate diagnosis of inflammatory pathologies, before the appearance of morphological changes on imaging.
The objectives of this study were to study the diagnostic accuracy of DWI in the diagnosis of early acute interstitial pancreatitis.
The present retrospective observational study was conducted at the department of radiodiagnosis of a tertiary teaching hospital for 1 year. Fifty patients who underwent magnetic resonance imaging of the pancreas with clinical or laboratory diagnosis of early pancreatitis were included in the study. The diagnostic accuracy of DWI was analyzed on the basis of quantitative (apparent diffusion coefficient [ADC] values) evaluation in the diagnosis of early acute pancreatitis. Threshold values for ADC were derived for differentiation of inflamed versus normal pancreas. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) were obtained by drawing the receiver operating characteristic (ROC) curve.
The mean ADC values in the patient group (0.882 × 10 -3 mm 2 /s ± 0.102) were significantly lower than the control group (1.178 × 10 -3 mm 2 /s ± 0.232) with P < 0.001. The ROC curve deciphered a cutoff value of 0.937 × 10 -3 mm 2 /s with a sensitivity of 84%, specificity of 86%, PPV of 85.71%, and NPV of 84.31% for diagnosis of acute pancreatitis using quantitative ADC values.
DWI can thus be a succinct modality for early diagnosis of pancreatitis with excellent diagnostic accuracy and superlative advantage of lack of contrast and radiation in comparison to computed tomography scan.
扩散加权成像（DWI）已成为诊断包括胰腺在内的各种器官早期功能变化的一种更新的诊断方法。DWI已显示出在成像上出现形态学变化之前早期准确诊断炎症性病变的能力。
本研究的目的是探讨DWI在早期急性间质性胰腺炎诊断中的诊断准确性。
本回顾性观察研究在一家三级教学医院的放射诊断科进行了1年。纳入50例经临床或实验室诊断为早期胰腺炎并接受胰腺磁共振成像的患者。基于定量（表观扩散系数[ADC]值）评估分析DWI在早期急性胰腺炎诊断中的诊断准确性。得出ADC的阈值以区分发炎胰腺与正常胰腺。通过绘制受试者操作特征（ROC）曲线获得敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
患者组的平均ADC值（0.882×10⁻³mm²/s±0.102）显著低于对照组（1.178×10⁻³mm²/s±0.232），P<0.001。ROC曲线确定诊断急性胰腺炎的ADC临界值为0.937×10⁻³mm²/s，敏感性为84%，特异性为86%，PPV为85.71%，NPV为84.31%。
因此，与计算机断层扫描相比，DWI可以作为一种简洁的方法用于胰腺炎的早期诊断，具有出色诊断准确性以及无造影剂和辐射的突出优势
