Value of MR Diffusion-Weighted Imaging for Differentiating Pancreatic Carcinoma from Chronic Focal Pancreatitis on 3.0 T MR System_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Jinxiu , SONG Bin , WU Bi

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, ChinaCorresponding Author: SONG Bin， E-mail: cjr.songbin@vip.163.com;

Corresponding author：

Keywords：

Pancreatic carcinoma; Chronic focal pancreatitis; Magnetic resonance imaging; Diffusion-weighted imaging

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To investigate the value of MR diffusion-weighted imaging (DWI) in differentiating pancreatic carcinoma from chronic focal pancreatitis on 3.0 T MR system.
Methods 　Thirteen patients with proved pancreatic carcinoma, 7 patients with confirmed chronic focal pancreatitis, and 14 healthy volunteers, were included in this study. MR examination including the routine abdomen scanning protocol and DWI was performed for both patients and volunteers. The SE-EPI sequence and ASSET technique were used for DWI. The b values of 400, 600, 800 and 1 000 s/mm2 were selected to acquire the DWI. The corresponding apparent diffusion coefficient (ADC) values were measured in each designated region of interest and statistically analyzed.
Results 　①DWI of the healthy volunteers showed intermediate signals of pancreas. ②DWI of pancreatic tumor masses showed homogenous high signal intensity relative to the surrounding pancreatic tissue with clear boundary. Under different b values, the tumor ADC values were (1.63±0.235)×10-3 mm2/s, (1.42±0.126)×10-3mm2 /s, (1.36±0.170)×10-3 mm2 /s and (1.26±0.178)×10-3 mm2 /s respectively, which were significantly lower than those of non-tumor region 〔(2.11±0.444)×10-3 mm2 /s, (1.83±0.230)×10-3 mm2 /s, (1.81±0.426)×10-3 mm2 /s, (1.60±0.230)×10-3 mm2 /s〕 and of the normal pancreas 〔(1.85±0.350)×10-3 mm2 /s, (1.69±0.290)×10-3 mm2 /s, (1.67±0.268)×10-3 mm2 /s, (1.42±0.221)×10-3 mm2 /s〕， P＜0.05. ③DWI of chronic focal pancreatitis showed inhomogeneous slightly hyper-intense signal with blurring borders. Under different b values, the ADC values of the inflammatory masses of chronic pancreatitis were (169±0.150)×10-3 mm2 /s, (1.56±0.119)×10-3 mm2 /s, (1.59±0.172)×10-3 mm2/s and (1.35±0.080)×10-3 mm2 /s respectively, which were higher than those of pancreatic carcinoma. When b value was set to 800 s/mm2 , the difference in ADC values between pancreatic carcinoma and chronic focal pancreatitis was statistically significant (P＜0.05).
Conclusion 　MR DWI can clearly depict the tumor mass of pancreatic carcinoma. In addition, the measurement of ADC values can provide useful information for the differential diagnosis between pancreatic carcinoma and chronic focal pancreatitis.

Citation： CHEN Jinxiu,SONG Bin,WU Bi. Value of MR Diffusion-Weighted Imaging for Differentiating Pancreatic Carcinoma from Chronic Focal Pancreatitis on 3.0 T MR System. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(10): 779-783. doi: Copy

1.	van Gulik TM, Moojen TM, van Geenen R, et al. Differential diagnosis of focal pancreatitis and pancreatic cancer [Ｊ]. Ann Oncol, 1999; 10 Suppl 4∶85.
2.	杨洋，宋彬，吴苾. 慢性病毒性肝炎组织病理学分级和磁共振弥散成像的对照研究 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(4)∶469.
3.	邢悦，刘荣波. 肝脏磁共振弥散加权成像的研究进展 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(3)∶359.
4.	Hunsche S, Moseley ME, Stoeter P, et al. Diffusion-tensor MR imaging at 1.5 and 3.0 T: initial observations [Ｊ]. Radiology, 2001; 221(2)∶550.
5.	Edelman RR, Salanitri G, Brand R, et al. Magnetic resonance imaging of the pancreas at 3.0 tesla: qualitative and quantitative comparison with 1.5 tesla [Ｊ]. Invest Radiol, 2006; 41(2)∶175.
6.	宋彬, 闵鹏秋, 吴苾, 等. 磁共振VIBE序列鉴别胰腺癌与肿块型慢性胰腺炎的价值探讨 [Ｊ]. 放射学实践, 2006; 21(51)∶498.
7.	Le Bihan D, Breton E, Lallemand D, et al. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging [Ｊ]. Radiology, 1988; 168(2)∶497.
8.	Ichikawa T, Haradome H, Hachiya J, et al. Diffusion-weighted MR imaging with a single-shot echoplanar sequence: detection and characterization of focal hepatic lesions [Ｊ]. AJR Am J Roentgenol, 1998; 170(2)∶397.
9.	Kim T, Murakami T, Takahashi S, et al . Diffusion-weighted single-shot echoplanar MR imaging for liver disease [Ｊ]. AJR Am J Roentgenol, 1999; 173(2)∶393.
10.	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.
11.	Yamada I, Aung W, Himeno Y, et al. Diffusion coefficients in abdominal organs and hepatic lesions: evaluation with intravoxel incoherent motion echo-planar MR imaging [Ｊ]. Radiology, 1999; 210(3)∶617.
12.	Thoeny HC, De Keyzer F, Oyen RH, et al. Diffusion-weighted MR imaging of kidneys in healthy volunteers and patients with parenchymal diseases: initial experience [Ｊ]. Radiology， 2005; 235(3)∶911.
13.	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.
14.	Issa B. In vivo measurement of the apparent diffusion coefficient in normal and malignant prostatic tissues using echo-planar imaging [Ｊ]. J Magn Reson Imaging, 2002; 16(2)∶196.
15.	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.
16.	Sugahara T, Korogi Y, Kochi M, et al. Usefulness of diffusion-weighted MRI with echo-planar technique in the evaluation of cellularity in gliomas [Ｊ]. J Magn Reson Imaging, 1999; 9(1)∶53.
17.	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.
18.	Gabata T, Matsui O, Kadoya M, et al. Small pancreatic adenocarcinomas: efficacy of MR imaging with fat suppression and gadolinium enhancement [Ｊ]. Radiology, 1994; 193(3)∶683.
19.	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.
20.	Merkle EM, Dale BM. Abdominal MRI at 3.0 T: the basics revisited [Ｊ]. AJR Am J Roentgenol, 2006; 186(6)∶1524.

1. 　van Gulik TM, Moojen TM, van Geenen R, et al. Differential diagnosis of focal pancreatitis and pancreatic cancer [Ｊ]. Ann Oncol, 1999; 10 Suppl 4∶85.
2. 　杨洋，宋彬，吴苾. 慢性病毒性肝炎组织病理学分级和磁共振弥散成像的对照研究 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(4)∶469.
3. 　邢悦，刘荣波. 肝脏磁共振弥散加权成像的研究进展 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(3)∶359.
4. 　Hunsche S, Moseley ME, Stoeter P, et al. Diffusion-tensor MR imaging at 1.5 and 3.0 T: initial observations [Ｊ]. Radiology, 2001; 221(2)∶550.
5. 　Edelman RR, Salanitri G, Brand R, et al. Magnetic resonance imaging of the pancreas at 3.0 tesla: qualitative and quantitative comparison with 1.5 tesla [Ｊ]. Invest Radiol, 2006; 41(2)∶175.
6. 　宋彬, 闵鹏秋, 吴苾, 等. 磁共振VIBE序列鉴别胰腺癌与肿块型慢性胰腺炎的价值探讨 [Ｊ]. 放射学实践, 2006; 21(51)∶498.
7. 　Le Bihan D, Breton E, Lallemand D, et al. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging [Ｊ]. Radiology, 1988; 168(2)∶497.
8. 　Ichikawa T, Haradome H, Hachiya J, et al. Diffusion-weighted MR imaging with a single-shot echoplanar sequence: detection and characterization of focal hepatic lesions [Ｊ]. AJR Am J Roentgenol, 1998; 170(2)∶397.
9. 　Kim T, Murakami T, Takahashi S, et al . Diffusion-weighted single-shot echoplanar MR imaging for liver disease [Ｊ]. AJR Am J Roentgenol, 1999; 173(2)∶393.
10. 　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.
11. 　Yamada I, Aung W, Himeno Y, et al. Diffusion coefficients in abdominal organs and hepatic lesions: evaluation with intravoxel incoherent motion echo-planar MR imaging [Ｊ]. Radiology, 1999; 210(3)∶617.
12. 　Thoeny HC, De Keyzer F, Oyen RH, et al. Diffusion-weighted MR imaging of kidneys in healthy volunteers and patients with parenchymal diseases: initial experience [Ｊ]. Radiology， 2005; 235(3)∶911.
13. 　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.
14. 　Issa B. In vivo measurement of the apparent diffusion coefficient in normal and malignant prostatic tissues using echo-planar imaging [Ｊ]. J Magn Reson Imaging, 2002; 16(2)∶196.
15. 　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.
16. 　Sugahara T, Korogi Y, Kochi M, et al. Usefulness of diffusion-weighted MRI with echo-planar technique in the evaluation of cellularity in gliomas [Ｊ]. J Magn Reson Imaging, 1999; 9(1)∶53.
17. 　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.
18. 　Gabata T, Matsui O, Kadoya M, et al. Small pancreatic adenocarcinomas: efficacy of MR imaging with fat suppression and gadolinium enhancement [Ｊ]. Radiology, 1994; 193(3)∶683.
19. 　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.
20. 　Merkle EM, Dale BM. Abdominal MRI at 3.0 T: the basics revisited [Ｊ]. AJR Am J Roentgenol, 2006; 186(6)∶1524.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Value of MR Diffusion-Weighted Imaging for Differentiating Pancreatic Carcinoma from Chronic Focal Pancreatitis on 3.0 T MR System

Abstract Full text Figures/Tables Video References Cited by

Format

Content