• 四川大學(xué)華西醫(yī)院放射科（成都610041）;

目的 　總結(jié)各種磁共振（MR）功能成像的原理及在胰腺癌及腫塊型慢性胰腺炎診斷中的應(yīng)用價值。
方法 　回顧分析國內(nèi)、外近年來關(guān)于MR波譜成像、MR彌散成像及MR灌注成像在胰腺癌及慢性胰腺炎診斷和鑒別診斷中應(yīng)用的文獻(xiàn)。
結(jié)果 　胰腺癌與慢性胰腺炎在分子擴(kuò)散、生化代謝、組織灌注等方面存在差異，MR功能成像方法能反映這些差異而用于鑒別診斷。
結(jié)論 　MR功能成像作為一種非侵入性的影像檢查方法，能夠提供鑒別胰腺癌與腫塊型慢性胰腺炎有價值的信息。

引用本文： 陳錦秀,宋彬,吳苾. 磁共振功能成像鑒別胰腺癌與腫塊型慢性胰腺炎的價值. 中國普外基礎(chǔ)與臨床雜志, 2007, 14(6): 722-725. doi: 復(fù)制

1. 　Steer ML, Waxman I, Freedman S. Chronic pancreatitis [J]. N Engl J Med, 1995; 332(22)∶1482.
2. 　葛春林， 郭克建. 胰腺癌可切除性的判斷 [J]. 中國普外基礎(chǔ)與臨床雜志， 2003； 10（6）∶526.
3. 　Niederau C, Grendell JH. Diagnosis of pancreatic carcinoma. Imaging techniques and tumor markers [J]. Pancreas, 1992; 7(1)∶66.
4. 　Gudjonsson B, Livstone EM, Spiro HM. Cancer of the pancreas: diagnostic accuracy and survival statistics [J]. Cancer, 1978; 42(5)∶2494.
5. 　宋彬, 閔鵬秋, 吳苾, 等. 磁共振VIBE序列鑒別胰腺癌與腫塊型慢性胰腺炎的價值探討 [J]. 放射學(xué)實踐, 2006; 21(51)∶498.
6. 　Henriksen O. MR spectroscopy in clinical research [J]. Acta Radiol, 1994; 35(2)∶96.
7. 　Cho SG, Lee DH, Lee KY, et al. Differentiation of chronic focal pancreatitis from pancreatic carcinoma by in vivo proton magnetic resonance spectroscopy [J]. J Comput Assist Tomogr, 2005; 29(2)∶163.
8. 　Kim T, Murakami T, Takamura M, et al. Pancreatic mass due to chronic pancreatitis: correlation of CT and MR imaging features with pathologic findings [J]. AJR Am J Roentgenol, 2001; 177(2)∶367.
9. 　Cho SG, Kim YS, Kim HJ, et al. Chronic hepatitis: in vivo proton MR spectroscopic evaluation of the liver and correlation with histopathologic findings [J]. Radiology, 2001; 221(3)∶740.
10. 　Kaplan O, Kushnir T, Askenazy N, et al. Role of nuclear magnetic resonance spectroscopy (MRS) in cancer diagnosis and treatment: 31P, 23Na, and 1H MRS studies of three models of pancreatic cancer [J]. Cancer Res, 1997; 57(8)∶1452.
11. 　Wright CE, Tallan HH, Lin YY, et al. Taurine: biological update [J]. Annu Rev Biochem, 1986; 55∶427.
12. 　Moreno A, Rey M, Montane JM, et al. 1H NMR spectroscopy of colon tumors and normal mucosal biopsies; elevated taurine levels and reduced polyethyleneglycol absorption in tumors may have diagnostic significance [J]. NMR Biomed, 1993; 6(2)∶111.
13. 　Remy C, Arus C, Ziegler A, et al. In vivo, ex vivo, and in vitro one- and two-dimensional nuclear magnetic resonance spectroscopy of an intracerebral glioma in rat brain: assignment of resonances [J]. J Neurochem, 1994; 62(1)∶166.
14. 　Chemin-Thomas C, Palévody C, Esclassan J, et al. Combined magnetic resonance imaging and spectrometry for characterization of human pancreatic adenocarcinoma (Capan-1) heterotransplanted in nude mice [J]. Gastroenterol Clin Biol, 1994; 18(10)∶859.
15. 　Khan SA, Cox IJ, Thillainayagam AV, et al. Proton and phosphorus-31 nuclear magnetic resonance spectroscopy of human bile in hepatopancreaticobiliary cancer [J]. Eur J Gastroenterol Hepatol, 2005; 17(7)∶733.
16. 　Pierpaoli C, Righini A, Linfante I, et al. Histopathologic correlates of abnormal water diffusion in cerebral ischemia: diffusion-weighted MR imaging and light and electron microscopic study [J]. Radiology, 1993; 189(2)∶439.
17. 　邢悅， 劉榮波. 肝臟磁共振彌散加權(quán)成像的研究進(jìn)展 [J]. 中國普外基礎(chǔ)與臨床雜志， 2007； 14（3）∶359.
18. 　楊洋， 宋彬， 吳苾. 慢性病毒性肝炎組織病理學(xué)分級和磁共振彌散成像的對照研究 [J]. 中國普外基礎(chǔ)與臨床雜志， 2006； 13（4）∶469.
19. 　Roth Y, Tichler T, Kostenich G, et al. High-b-value diffusion-weighted MR imaging for pretreatment prediction and early monitoring of tumor response to therapy in mice [J]. Radiology, 2004; 232(3)∶685.
20. 　Lyng H, Haraldseth O, Rofstad EK. Measurement of cell density and necrotic fraction in human melanoma xenografts by diffusion weighted magnetic resonance imaging [J]. Magn Reson Med, 2000; 43(6)∶828.
21. 　Yoshikawa T, Kawamitsu H, Mitchell DG, et al. ADC measurement of abdominal organs and lesions using parallel imaging technique [J]. AJR Am J Roentgenol, 2006; 187(6)∶1521.
22. 　Taouli B, Vilgrain V, Dumont E, et al. Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences: prospective study in 66 patients [J]. Radiology, 2003; 226(1)∶71.
23. 　Sinha S, Lucas-Quesada FA, Sinha U, et al. In vivo diffusion-weighted MRI of the breast: potential for lesion characterization [J]. J Magn Reson Imaging, 2002; 15(6)∶693.
24. 　Katayama M, Masui T, Kobayashi S, et al. Diffusion-weighted echo planar imaging of ovarian tumors: is it useful to measure apparent diffusion coefficients? [J]. J Comput Assist Tomogr, 2002; 26(2)∶250.
25. 　任瑩, 金征宇, 馮逢, 等. 3.0T磁共振擴(kuò)散加權(quán)成像對胰腺癌的診斷價值初探 [J]. 中國醫(yī)學(xué)影像技術(shù), 2006; 22(4) ∶581.
26. 　Ichikawa T, Haradome H, Hachiya J, et al. Diffusion-weighted MR imaging with single-shot echo-planar imaging in the upper abdomen: preliminary clinical experience in 61 patients [J]. Abdom Imaging, 1999; 24(5)∶456.
27. 　Ichikawa T, Erturk SM, Motosugi U, et al. High-b value diffusion-weighted MRI for detecting pancreatic adenocarcinoma: preliminary results [J]. AJR Am J Roentgenol, 2007; 188(2)∶409.
28. 　Hosten N, Lemke AJ, Wiedenmann B, et al. Combined imaging techniques for pancreatic cancer [J]. Lancet, 2000; 356(9233)∶909.
29. 　Tajima Y, Kuroki T, Tsutsumi R, et al. Pancreatic carcinoma coexisting with chronic pancreatitis versus tumor-forming pancreatitis: diagnostic utility of the time-signal intensity curve from dynamic contrast-enhanced MR imaging [J]. World J Gastroenterol, 2007; 13(6)∶858.
30. 　吳苾， 宋彬. 影像學(xué)新技術(shù)在消化系統(tǒng)的臨床應(yīng)用 [J]. 中國普外基礎(chǔ)與臨床雜志， 2007； 14（2）∶222.
  1. 1. 　Steer ML, Waxman I, Freedman S. Chronic pancreatitis [J]. N Engl J Med, 1995; 332(22)∶1482.
  2. 2. 　葛春林， 郭克建. 胰腺癌可切除性的判斷 [J]. 中國普外基礎(chǔ)與臨床雜志， 2003； 10（6）∶526.
  3. 3. 　Niederau C, Grendell JH. Diagnosis of pancreatic carcinoma. Imaging techniques and tumor markers [J]. Pancreas, 1992; 7(1)∶66.
  4. 4. 　Gudjonsson B, Livstone EM, Spiro HM. Cancer of the pancreas: diagnostic accuracy and survival statistics [J]. Cancer, 1978; 42(5)∶2494.
  5. 5. 　宋彬, 閔鵬秋, 吳苾, 等. 磁共振VIBE序列鑒別胰腺癌與腫塊型慢性胰腺炎的價值探討 [J]. 放射學(xué)實踐, 2006; 21(51)∶498.
  6. 6. 　Henriksen O. MR spectroscopy in clinical research [J]. Acta Radiol, 1994; 35(2)∶96.
  7. 7. 　Cho SG, Lee DH, Lee KY, et al. Differentiation of chronic focal pancreatitis from pancreatic carcinoma by in vivo proton magnetic resonance spectroscopy [J]. J Comput Assist Tomogr, 2005; 29(2)∶163.
  8. 8. 　Kim T, Murakami T, Takamura M, et al. Pancreatic mass due to chronic pancreatitis: correlation of CT and MR imaging features with pathologic findings [J]. AJR Am J Roentgenol, 2001; 177(2)∶367.
  9. 9. 　Cho SG, Kim YS, Kim HJ, et al. Chronic hepatitis: in vivo proton MR spectroscopic evaluation of the liver and correlation with histopathologic findings [J]. Radiology, 2001; 221(3)∶740.
  10. 10. 　Kaplan O, Kushnir T, Askenazy N, et al. Role of nuclear magnetic resonance spectroscopy (MRS) in cancer diagnosis and treatment: 31P, 23Na, and 1H MRS studies of three models of pancreatic cancer [J]. Cancer Res, 1997; 57(8)∶1452.
  11. 11. 　Wright CE, Tallan HH, Lin YY, et al. Taurine: biological update [J]. Annu Rev Biochem, 1986; 55∶427.
  12. 12. 　Moreno A, Rey M, Montane JM, et al. 1H NMR spectroscopy of colon tumors and normal mucosal biopsies; elevated taurine levels and reduced polyethyleneglycol absorption in tumors may have diagnostic significance [J]. NMR Biomed, 1993; 6(2)∶111.
  13. 13. 　Remy C, Arus C, Ziegler A, et al. In vivo, ex vivo, and in vitro one- and two-dimensional nuclear magnetic resonance spectroscopy of an intracerebral glioma in rat brain: assignment of resonances [J]. J Neurochem, 1994; 62(1)∶166.
  14. 14. 　Chemin-Thomas C, Palévody C, Esclassan J, et al. Combined magnetic resonance imaging and spectrometry for characterization of human pancreatic adenocarcinoma (Capan-1) heterotransplanted in nude mice [J]. Gastroenterol Clin Biol, 1994; 18(10)∶859.
  15. 15. 　Khan SA, Cox IJ, Thillainayagam AV, et al. Proton and phosphorus-31 nuclear magnetic resonance spectroscopy of human bile in hepatopancreaticobiliary cancer [J]. Eur J Gastroenterol Hepatol, 2005; 17(7)∶733.
  16. 16. 　Pierpaoli C, Righini A, Linfante I, et al. Histopathologic correlates of abnormal water diffusion in cerebral ischemia: diffusion-weighted MR imaging and light and electron microscopic study [J]. Radiology, 1993; 189(2)∶439.
  17. 17. 　邢悅， 劉榮波. 肝臟磁共振彌散加權(quán)成像的研究進(jìn)展 [J]. 中國普外基礎(chǔ)與臨床雜志， 2007； 14（3）∶359.
  18. 18. 　楊洋， 宋彬， 吳苾. 慢性病毒性肝炎組織病理學(xué)分級和磁共振彌散成像的對照研究 [J]. 中國普外基礎(chǔ)與臨床雜志， 2006； 13（4）∶469.
  19. 19. 　Roth Y, Tichler T, Kostenich G, et al. High-b-value diffusion-weighted MR imaging for pretreatment prediction and early monitoring of tumor response to therapy in mice [J]. Radiology, 2004; 232(3)∶685.
  20. 20. 　Lyng H, Haraldseth O, Rofstad EK. Measurement of cell density and necrotic fraction in human melanoma xenografts by diffusion weighted magnetic resonance imaging [J]. Magn Reson Med, 2000; 43(6)∶828.
  21. 21. 　Yoshikawa T, Kawamitsu H, Mitchell DG, et al. ADC measurement of abdominal organs and lesions using parallel imaging technique [J]. AJR Am J Roentgenol, 2006; 187(6)∶1521.
  22. 22. 　Taouli B, Vilgrain V, Dumont E, et al. Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences: prospective study in 66 patients [J]. Radiology, 2003; 226(1)∶71.
  23. 23. 　Sinha S, Lucas-Quesada FA, Sinha U, et al. In vivo diffusion-weighted MRI of the breast: potential for lesion characterization [J]. J Magn Reson Imaging, 2002; 15(6)∶693.
  24. 24. 　Katayama M, Masui T, Kobayashi S, et al. Diffusion-weighted echo planar imaging of ovarian tumors: is it useful to measure apparent diffusion coefficients? [J]. J Comput Assist Tomogr, 2002; 26(2)∶250.
  25. 25. 　任瑩, 金征宇, 馮逢, 等. 3.0T磁共振擴(kuò)散加權(quán)成像對胰腺癌的診斷價值初探 [J]. 中國醫(yī)學(xué)影像技術(shù), 2006; 22(4) ∶581.
  26. 26. 　Ichikawa T, Haradome H, Hachiya J, et al. Diffusion-weighted MR imaging with single-shot echo-planar imaging in the upper abdomen: preliminary clinical experience in 61 patients [J]. Abdom Imaging, 1999; 24(5)∶456.
  27. 27. 　Ichikawa T, Erturk SM, Motosugi U, et al. High-b value diffusion-weighted MRI for detecting pancreatic adenocarcinoma: preliminary results [J]. AJR Am J Roentgenol, 2007; 188(2)∶409.
  28. 28. 　Hosten N, Lemke AJ, Wiedenmann B, et al. Combined imaging techniques for pancreatic cancer [J]. Lancet, 2000; 356(9233)∶909.
  29. 29. 　Tajima Y, Kuroki T, Tsutsumi R, et al. Pancreatic carcinoma coexisting with chronic pancreatitis versus tumor-forming pancreatitis: diagnostic utility of the time-signal intensity curve from dynamic contrast-enhanced MR imaging [J]. World J Gastroenterol, 2007; 13(6)∶858.
  30. 30. 　吳苾， 宋彬. 影像學(xué)新技術(shù)在消化系統(tǒng)的臨床應(yīng)用 [J]. 中國普外基礎(chǔ)與臨床雜志， 2007； 14（2）∶222.