Yadav Sudhir K, Liu Ling, Zheng Penglou, Dhakal Vivek, Shah Sanjyoti, Adhikari Abhishek, Kanodia Ravi
Department of Radiology, The First Affiliated Hospital of Dali University, Dali, CHN.
Department of Radiology, Nepal Mediciti Hospital, Kathmandu, NPL.
Cureus. 2024 Oct 8;16(10):e71051. doi: 10.7759/cureus.71051. eCollection 2024 Oct.
The study assessed the diagnostic value of diffusion-weighted imaging (DWI) and mean apparent diffusion coefficient (ADC) in early acute interstitial edematous pancreatitis (AIEP). Fifty-six AIEP patients and 60 healthy controls underwent an upper abdominal magnetic resonance (MR) examination. The pancreas diameter and ADC values were measured and analyzed across age and gender groups. Results showed that the pancreas diameter varied with sex and age, with smaller diameters in females and the elderly. Mean ADC values were not significantly affected by age or sex. Signal changes were observed in AIEP patients' images, with DWI showing a higher positive rate than T1WI and T2WI. Comparing the control and AIEP groups, the pancreas diameter was significantly larger in AIEP patients, particularly the pancreatic tail in males. ADC values were significantly lower in AIEP patients, and the difference was more pronounced at b=800 s/mm² compared to b=500 s/mm². Mean ADC exhibited good diagnostic potential for early AIEP, with higher sensitivity and specificity values than serum amylase levels. The area under the receiver operating characteristic (ROC) curve (AUC) indicated that the diagnostic value was better at b=800 s/mm² than at b=500 s/mm². In conclusion, the study found that normal pancreas diameter is influenced by sex and age, with smaller diameters in females and the elderly. Mean ADC values were not affected by these factors. Early AIEP could not be diagnosed solely based on pancreas diameter changes. DWI combined with Mean ADC demonstrated high diagnostic value for early AIEP.
本研究评估了扩散加权成像（DWI）和平均表观扩散系数（ADC）在早期急性间质性水肿性胰腺炎（AIEP）中的诊断价值。56例AIEP患者和60例健康对照者接受了上腹部磁共振（MR）检查。对胰腺直径和ADC值按年龄和性别组进行了测量和分析。结果显示，胰腺直径随性别和年龄而变化，女性和老年人的直径较小。平均ADC值不受年龄或性别的显著影响。在AIEP患者的图像中观察到信号变化，DWI显示出比T1WI和T2WI更高的阳性率。比较对照组和AIEP组，AIEP患者的胰腺直径明显更大，尤其是男性的胰尾。AIEP患者的ADC值明显更低，与b = 500 s/mm²相比，在b = 800 s/mm²时差异更明显。平均ADC对早期AIEP具有良好的诊断潜力，其敏感性和特异性值高于血清淀粉酶水平。受试者操作特征（ROC）曲线下面积（AUC）表明，b = 800 s/mm²时的诊断价值优于b = 500 s/mm²时。总之，研究发现正常胰腺直径受性别和年龄影响，女性和老年人的直径较小。平均ADC值不受这些因素影响。不能仅根据胰腺直径变化诊断早期AIEP。DWI联合平均ADC对早期AIEP具有较高的诊断价值。
