IVIM联合DTI对急性胰腺炎定量诊断与严重程度分级的价值

李兴辉; 王健; 陈天武; 张小明

doi:10.16016/j.1000-5404.201811156

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IVIM联合DTI对急性胰腺炎定量诊断与严重程度分级的价值

临床医学 | 更新时间：2026-01-09

- IVIM联合DTI对急性胰腺炎定量诊断与严重程度分级的价值
- Quantitative diagnosis and grading of acute pancreatitis by intravoxel incoherent motion diffusion combined with diffusion tensor imaging
- 第三军医大学学报 2019年41卷第5期页码：482-489
- 作者机构：
  
  1.400038 重庆，陆军军医大学(第三军医大学)第一附属医院放射科
  2.637000 四川南充，四川省医学影像学重点实验室，川北医学院附属医院放射科
- 作者简介：
  
  [王健，E-mail: 270969522@qq.com WANG Jian, E-mail: 270969522@qq.com
- 基金信息：
  
  国家自然科学基金面上项目(81871440);四川省教育厅基金(18ZNB0209)
- DOI：10.16016/j.1000-5404.201811156
  中图分类号： R445.2;R576.04
- 收稿：2018-11-21，
  
  修回：2018-11-29，
  
  纸质出版：2019-03-15
- 稿件说明：
移动端阅览
李兴辉, 王健, 陈天武, 等. IVIM联合DTI对急性胰腺炎定量诊断与严重程度分级的价值[J]. 第三军医大学学报, 2019,41(5):482-489.

Xinghui LI, Jian WANG, Tianwu CHEN, et al. Quantitative diagnosis and grading of acute pancreatitis by intravoxel incoherent motion diffusion combined with diffusion tensor imaging[J]. Journal of Third Military Medical University, 2019, 41(5): 482-489.
李兴辉, 王健, 陈天武, 等. IVIM联合DTI对急性胰腺炎定量诊断与严重程度分级的价值[J]. 第三军医大学学报, 2019,41(5):482-489. DOI： 10.16016/j.1000-5404.201811156.

Xinghui LI, Jian WANG, Tianwu CHEN, et al. Quantitative diagnosis and grading of acute pancreatitis by intravoxel incoherent motion diffusion combined with diffusion tensor imaging[J]. Journal of Third Military Medical University, 2019, 41(5): 482-489. DOI： 10.16016/j.1000-5404.201811156.

摘要

目的

研究体素内不相干运动扩散加权成像(intravoxel incoherent motion diffusion-weighted imaging，IVIM-DWI)与扩散张量成像(diffusion tensor imaging，DTI)对急性胰腺炎(acute pancreatitis，AP)的定量诊断和严重程度分级的评估价值。

方法

采用3.0T MR对85例AP患者(AP组)和20例健康志愿者(对照组)行上腹部常规、IVIM和DTI序列扫描，测量胰腺单指数模型下参数(standard average diffusion coefficient

ADC)及双指数模型下的参数(slow ADC、fast ADC及fraction of fast ADC，Ff ADC)和DTI的参数(ADC和fractional anisotropy

FA)。比较其对AP的诊断效能，并与AP MR严重程度指数(MR severity index

MRSI)进行相关分析。

结果

AP组与对照组Standard ADC、Ff ADC及DTI的ADC、FA差异具有统计学意义，Slow ADC、Fast ADC值差异无统计学意义。standard ADC、Ff ADC、DTI的ADC、FA有诊断效能(曲线下面积分别为0.692、0.707、0.676、0.669，

0.05)，但四者之间诊断效能差异无统计学意义。standard ADC、Ff ADC、DTI的ADC、FA与AP MR严重程度指数之间呈负相关(R分别为-0.419、-0.271、-0.391、-0.339，

0.05)，而slow ADC、fast ADC值与MRSI评分不具有相关性。

结论

胰腺的IVIM和DTI参数的测量可作为诊断AP和严重程度影像分期的依据之一。

Abstract

Objective

To investigate the diagnostic value and grading of acute pancreatitis (AP) using intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and diffusion tensor imaging (DTI).

Methods

Eighty-five patients with AP and 20 healthy volunteers admitted in Affiliated Hospital of North Sichuan Medical College from March to December 2016 were enrolled in the study. All patients underwent routine abdominal

IVIM and DTI sequence scans. The standard average diffusion coefficient (ADC)

slow ADC

fast ADC and fraction of fast ADC (Ff ADC) derived form monoexponential and biexponential model were measured

and the ADC and fractional anisotropy (FA) obtained from DTI were calculated. The diagnostic efficacy of AP was compared and the relationships between these indexes and AP MR severity index (MRSI) were analyzed.

Results

There were statistically significant differences in the standard ADC and Ff ADC and in ADC and FA of DTI between the experimental group and the control group. But the differences of slow ADC and fast ADC had no statistical difference. The standard ADC

Ff ADC

and the ADC and FA of DTI had higher diagnostic values for AP (the area under the curve are 0.692

0.707

0.676 and 0.669

respectively

0.05)

no statistically significant differences were seen among the 4 indexes. The standard ADC and Ff ADC

and the ADC and FA of DTI were negatively correlated with the severity of AP based on MRSI

respectively (

=-0.419

-0.271

-0.391

-0.339

0.05). However

the slow ADC and fast ADC value had no correlation with the MRSI score.

Conclusion

IVIM and DTI parameters in the pancreas can be used for the diagnosis and image grading of AP.

关键词

Keywords

references

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