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1、第三部分胰腺癌MRI检查新方法的初步探讨摘要目的:探讨胰腺癌MR工检查的新方法，旨在同时兼顾病灶的检出定性及胰周血管侵犯的评价两方面。材料与方法:搜集20例临床怀疑或CT诊断明确为胰腺癌病例。检查方法:所有患者均行平扫的SET,W工、FSETZWI和SET,WI+FS序列扫描，增强扫描方法为:注射对比剂后，第一回合采用抑脂的efgre3D序列，行直接冠状位扫描，第二回合采用横断位2DDCEFMPSPGR序列，行胰腺区横断位的薄层扫描，第三回合重复第一回合扫描，第四回合行整个上腹部(包括肝脏)的厚层扫描。如此反复行冠状位及横断位交叉的共四个回合扫描，其中一、三回合
2、数据用于3DDCEMRA重建，主要为显示胰周血管，第二、四回合主要为显示病灶、明确性质。结果:行该方法检查的20例患者，最终手术及随访证实胰腺癌19例，胰腺炎1例，19例胰腺癌术前MR技术均明确诊断，诊断准确率为10090。手术患者中，共3例7条血管受侵，其中MRA术前诊断正确6条，漏诊1条，横断位术前全部诊断正确，但同时MRA与横断位均将3条正常无侵犯血管误诊为受侵犯。结论:利用GE1.5TSignaMR机，采用冠状位和横断位交叉扫描技术，能够同时兼顾胰腺癌病灶的检出定性及胰周血管侵犯的评价。关键词:方法胰腺癌磁共振成像ABSTRACTTheInvasiono
3、fPancreaticCarcinomatoPeripancreaticVessels:EvaluatingtheReseetabilitywithNMandMRAngiographyPartonePancreaticCarcinomaInvasiontoPeripancreaticVessels:EvaluationtheResectabilitywithIIRIAbstractObjective:Todiscussthesensitivity,specificityandaccuracyofMRIinevaluatingtheinvasionofpancre
4、aticcarcinomatosurroundingvessels,andtofurtherevaluatetheoptimalscanningsequences.Materialsandmethods:Twenty-twocasesconfirmedpancreaticcarcinomaswithsurgeo-pathologywerecollected,towhichMRIsequencessuchasSET,WI,T尸IanddynamiccontrastenhancedGREtriphasescanswereperformed.Theinvasionof
5、peripancreaticvesselswereretrospectivelyanalyzed.Accordingtotheinvasiondegree,suchgradingmethodas0-V3gradeswasemployedforblindedscoring,thenumbersofvesselsinvasionandnon-invasionwerecalculated,andcomparedwiththefindingsofsurgery.Andtheaccuracyofeachgradeforvesselsinvasionwerestudied,
6、thesensitivity,specificity,positivepredictivevalue,negativepredictivevalueandaccuracyforSET,WIandDCEFMPSPGRwerealsocalculatedrespectively.Results:Totally,154vesselsoftwentytwocaseswereinvolved,51vesselswereinvasiveand103vesselswerenon-invasive.Thesensitivity,specificity,positivepredi
7、ctivevalue,negativepredictivevalueandaccuracyofSET,WI,DCEFMPSPGRandSET,WI+DCEFMPSPGRforvesselsinvasionwere:88.2%,97.0%,93.8%,94.3%,94.2%;84.3%,98.0%,95.5%,92.7%,93.5%;92.1%,98.0%,95.9%,96.2%.96.1%respectively.Conclusions:Thesensitivity,specificityandoverallaccuracyofMRIforperipancrea
8、ticvesselsin
