Evaluation of 2D and 3D MRI imaging in the diagnosis of pancreatic carcinoma
Wang, D-qing.; Zeng, M-su.; Jin, D-yong.; Lou, W-hui.; Ji, Y.; Rao, S-xiang.; Chen, C-zhong.; Li, R-chen.
Zhonghua Zhong Liu Za Zhi 29(3): 216-220
2007
ISSN/ISBN: 0253-3766 PMID: 17649641 Document Number: 606626
Objective To evaluate various kinds of sequences and modified dynamic contrastenhanced MRI methods in the diagnosis of pancreatic carcinoma. Methods Forty-nine pancreatic carcinoma patients proved by histopathology or clinical examination and follow-up underwent MR examination. Plain MR sequences included: T1-weighted 2D FLASH, T1WI 3D VIBE, TSE T2WI and HASTE with FS. Modified dynamic contrast-enhanced scanning procedures were coronal scaning with 3D FLASH and axial scaning using T1WI 3D VIBE sequences in turn for the upper abdominal area and pancreatic area. The coronal imaging were used to obtain 3D peripancreatic vessels during arterial phase and portal vein phase scanning, respectively. The axial imaging were used to detect the tumor in pancreatic parenchymal phase and delayed phase scanning, respectively. Final scanning for the whole upper abdomen was performed using T1WI 2D FLASH axial sequence. Results (1) Of 49 lesions in these patients, 45 showed hypo-intensity and 4 iso-intensity on 3D VIBE. Forty-six lesions showed hypo-intensity and 3 iso-intensity on 2D FLASH. On TSE T-2 + FS, lesion contour was not clear enough; 3 of them displayed iso-intensity, the other showed iso- or hyper-intensity. (2) During pancreatic parenchymal phase, 48 lesions showed hypo-intensity and 39 ring enhancement. Twenty-four lesions displayed marginal tubercle and inner compartment enhancement during portal vein and delayed phase. Six lesions showed iso- or hyper-intensity in delayed phase. (3) Thirty-seven patients underwent surgical exploration. MRI and MRA had a good correlation with surgical findings for peripancreatic vessels which were diagnosed as being invasive or non-invasive by tumors except three superior mesenteric arteries and four superior mesenteric veins being misdiagnosed. Conclusion As "one-stop-shop" MRI examination, modified MRI sequences consisting of dynamic coronal and axial contrast-enhanced scanning is feasible and helpful in diagnosing, staging and assessing the resectability for pancreatic carcinoma.