Objective To investigate the value of MRI united-sequence examination in differential diagnosis between pan-creatic carcinoma and chronic massive pancreatitis( CMP) . Methods Upper-abdominal MR imaging data of 26 patients with pan-creatic carcinoma and 15 patients with CMP were retrospectively analyzed, all patients underwent entire MR sequences examination and were proved by surgical-pathological findings or unequivocal clinical follow-up results. Morphological characteristics of pancre-atic mass,signal features of mass on plain-scan and multi-phases dynamic contrast-enhanced images,changes of pancreatic duct and biliary duct,having or not involvement of peripancreatic blood vessels, invasion of neighboring structures and organs by the pancreatic mass or metastasis,were focused. Corresponding each imaging finding were compared with χ2 test between two teams. n Results These differences had statistical significance in two teams(P<0. 05),that included mass locations,clear or unclear border of mass,signal homogeneity of mass,occurrence rate of “little bubble sign”, morphological changes of pancreatic duct at the site of the pancreatic mass and the proximal( upstream) to mass, hepatic metastasis and thickening anterior renal fascia. However,the differ-ence had not statistical significant between the two groups regarding peripancreatic blood vessels encasement of mass ( P>0. 05 ) . Conclusion MRI united-sequence examination is able to accurately depict all sorts of imaging findings of pancreatic carcinoma and CMP,accuracy in the differential diagnosis of the two disease entities could be improved by comprehensive analysis of these imaging features.%目的探讨MRI联合序列检查在胰腺癌与慢性肿块型胰腺炎( chronic massive pancreatitis,CMP)鉴别诊断中的价值。方法回顾性分析26例胰腺癌、15例CPM患者的上腹部MRI影像学资料,所有患者MRI检查序列完整且均经手术病理或临床随访结果证实。重点观察胰腺肿块的形态学特点、肿块的平扫及多期强化特征、胰管及胆管的改变、胰周血管有无受累、胰周组织器官受累及转移情况等,并利用χ2检验对两组病例的对应影像学表现进行统计学分析。结果n 两组病例在肿块发生部位、肿块边界是否清楚、肿块信号均匀性、“小泡征”出现率、肿块处及肿块近端胰管的形态学改变、肝转移及肾前筋膜增厚差异有统计学意义( P<0.05),肿块包绕胰周血管差异无统计学意义( P>0.05)。结论MRI联合序列检查可以准确显示胰腺癌与慢性肿块型胰腺炎的各种影像学特征,综合分析这些影像学特点可以提高二者鉴别诊断的准确性。
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