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《Chinese Journal of Medical Imaging Technology》 2010-09
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Dynamic contrast-enhanced MRI in differentiation of pancreatic carcinoma from mass-forming focal pancreatitis

ZHANG Ting-ting, WANG Li, LU Jian-ping, BAI Mei(Department of Radiology, Changhai Hospital, the Second Military Medical University, Shanghai 200433, China)  
Objective To observe the value of multi-phase dynamic contrast enhancement MRI (DCE-MRI) in diagnosis and differential diagnosis of pancreatic carcinoma (PC) and mass-forming focal pancreatitis (FP). Methods All the subjects underwent five phases DCE-MRI were divided into 3 groups, i.e. pancreatic carcinoma (n=28) confirmed by pathology, mass-forming focal pancreatitis (n=15) confirmed by pathology or clinical diagnosis, and normal pancreas (n=20). Signal intensity of ROI was measured at the pancreas on all five phases, and for each, the enhanced rate was calculated. Meanwhile, time-signal intensity curves (TIC) of the mass and the remaining pancreas were obtained in all the groups. Then the patterns of the TICs were classified into 5 types according to the time of a peak (18 s, 45 s, 75 s, 150 s, 240 s after bolus injection of contrast material), namely, type-Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ, respectively. Then according to the profile of the tail of TIC, the type of the masses were classified into two subtypes, subtype-a (slow decline) and subtype-b (plateau). Results All normal pancreases had demonstrated TIC type-Ⅰ. Type-Ⅳb and type-Ⅴ TIC were only recognized in PC (P=0.036, 0.008), while type-Ⅰa and type-Ⅱa only in FP (P=0.037, 0.001). Furthermore, type-Ⅰ TIC in the remaining pancreas was recognized more in PC than FP (P=0.027). Besides, in the arterial phase, enhanced rate in PC was lower than in FP (P=0.031). Conclusion Multi-phases DCE-MRI may help to differentiate PC from mass-forming FP.
【CateGory Index】: R735.9
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