慢性胰腺炎的MRI評價及功能評估_《中國普外基礎與臨床雜志》

作者：

劉圓圓 , 黃子星 ,  宋彬

四川大學華西醫院放射科（四川成都 610041）;

關鍵詞：

慢性胰腺炎磁共振成像磁共振胰膽管成像彌散加權成像促胰液素

視頻：

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目的　探討慢性胰腺炎的磁共振成像（MRI）評價及功能評估。
方法　復習關于慢性胰腺炎的MRI評價及外分泌功能評估的文獻。
結果　MRI能發現慢性胰腺炎中胰腺實質的早期改變（包括胰腺大小、實質信號和強化模式的改變），磁共振胰膽管成像（MRCP）能發現胰腺導管系統的改變，促胰液素刺激MRCP進一步提高了對胰管及其分支的顯示率，且可無創地評估胰腺的外分泌功能，同時結合了形態學和功能學評估。促胰液素刺激彌散加權成像也可作為另一種提供胰腺外分泌功能信息的無創檢查手段。
結論　常規MRI和（或）促胰液素刺激MRI可作為慢性胰腺炎（尤其是早期慢性胰腺炎）評估方法，同時進行形態學和功能學評估，但仍需進一步的研究驗證這些方法的診斷準確性。

引用本文： 劉圓圓,黃子星,宋彬. 慢性胰腺炎的MRI評價及功能評估. 中國普外基礎與臨床雜志, 2013, 20(2): 216-220. doi: 復制

1.	Forsmark CE. The early diagnosis of chronic pancreatitis[J]. Clin Gastroenterol Hepatol， 2008， 6(12)：1291-1293.
2.	Czakó L. Diagnosis of early-stage chronic pancreatitis by secretin-enhanced magnetic resonance cholangiopancreatography[J]. J Gastroenterol， 2007， 42 Suppl 17：113-117.
3.	Stevens T， Conwell DL， Zuccaro G. Pathogenesis of chronic pancreatitis：an evidence-based review of past theories and recent developments[J]. Am J Gastroenterol， 2004， 99(11)：2256-2270.
4.	Etemad B， Whitcomb DC. Chronic pancreatitis：diagnosis， classification， and new genetic developments[J]. Gastroenterology， 2001， 120(3)：682-707.
5.	Steer ML， Waxman I， Freedman S. Chronic pancreatitis[J]. N Engl J Med， 1995， 332(22)：1482-1490.
6.	Tamura R， Ishibashi T， Takahashi S. Chronic pancreatitis：MRCP versus ERCP for quantitative caliber measurement and qualitative evaluation[J]. Radiology， 2006， 238(3)：920-928.
7.	Coakley FV， Schwartz LH. Magnetic resonance cholangiopancreatography[J]. J Magn Reson Imaging， 1999， 9(2)：157–162.
8.	Takehara Y. Can MRCP replace ERCP?[J]. J Magn Reson Imaging， 1998， 8(3)：517-534.
9.	Matos C， Metens T， Devière J， et al. Pancreatic duct：morphologic and functional evaluation with dynamic MR pancreatography after secretin stimulation[J]. Radiology， 1997， 203(2)：435-441.
10.	Cappeliez O， Delhaye M， Devière J， et al. Chronic pancreatitis：evaluation of pancreatic exocrine function with MR pancreatography after secretin stimulation[J]. Radiology， 2000， 215(2)：358-364.
11.	Balci NC， Smith A， Momtahen AJ， et al. MRI and S-MRCP findings in patients with suspected chronic pancreatitis：correlation with endoscopic pancreatic function testing (ePFT)[J]. J Magn Reson Imaging， 2010， 31(3)：601-606.
12.	Schneider AR， Hammerstingl R， Heller M， et al. Does secretin-stimulated MRCP predict exocrine pancreatic insufficiency? A comparison with noninvasive exocrine pancreatic function tests[J]. J Clin Gastroenterol， 2006， 40(9)：851-855.
13.	Manfredi R， Costamagna G， Brizi MG， et al. Severe chronic pancreatitis versus suspected pancreatic disease：dynamic MR cholangiopancreatography after secretin stimulation[J]. Radiology， 2000， 214(3)：849-855.
14.	Sanyal R， Stevens T， Novak E， et al. Secretin-enhanced MRCP：review of technique and application with proposal for quantification of exocrine function[J]. AJR Am J Roentgenol， 2012， 198(1)：124-132.
15.	Manfredi R， Perandini S， Mantovani W， et al. Quantitative MRCP assessment of pancreatic exocrine reserve and its correlationwith faecal elastase-1 in patients with chronic pancreatitis[J]. Radiol Med， 2012， 117(2)：282-292.
16.	Schlaudraff E， Wagner HJ， Klose KJ， et al. Prospective evaluation of the diagnostic accuracy of secretin-enhanced magnetic resonance cholangiopancreaticography in suspected chronic pancreatitis[J]. Magn Reson Imaging， 2008， 26(10)：1367-1373.
17.	Sai JK， Suyama M， Kubokawa Y， et al. Diagnosis of mild chronic pancreatitis (Cambridge classification)：comparative study using secretin injection-magnetic resonance cholangiopancreatography and endoscopic retrograde pancreatography[J]. World J Gastroenterol， 2008， 14(8)：1218-1221.
18.	Chopra A， Alkaade S， Balci NC， et al. The effect of prior sphincterotomy on the secretin-stimulated magnetic resonance cholangiopancreatography (s-MRCP)[J]. Acad Radiol， 2009， 16(11)：1381-1385.
19.	Erturk SM， Ichikawa T， Motosugi U， et al. Diffusion-weighted MR imaging in the evaluation of pancreatic exocrine function before and after secretin stimulation[J]. Am J Gastroenterol， 2006， 101(1)：133-136.
20.	Balc? C. MRI assessment of chronic pancreatitis[J]. DiagnInterv Radiol， 2011， 17(3)：249-254.
21.	Akisik MF， Aisen AM， Sandrasegaran K， et al. Assessment of chronic pancreatitis：utility of diffusion-weighted MR imaging with secretin enhancement[J]. Radiology， 2009， 250(1)：103-109.
22.	Akisik MF， Sandrasegaran K， Jennings SG， et al. Diagnosis of chronic pancreatitis by using apparent diffusion coefficient measurements at 3.0-T MR following secretin stimulation[J]. Radiology， 2009， 252(2)：418-425.
23.	Balci NC， Momtahen AJ， Akduman EI， et al. Diffusion-weightedMRI of the pancreas：correlation with secretin endoscopic pancreatic function test (ePFT)[J]. Acad Radiol， 2008， 15(10)：1264-1268.
24.	Balci NC， Alkaade S， Magas L， et al. Suspected chronic pancre-atitis with normal MRCP：findings on MRI in correlation withsecretin MRCP[J]. J Magn Reson Imaging， 2008， 27(1)：125-131.
25.	Alkaade S， Cem Balci N， Momtahen AJ， et al. Normal pancreatic exocrine function does not exclude MRI/MRCP chronic pancreatitis findings[J]. J Clin Gastroenterol， 2008， 42(8)：950-955.
26.	Balci NC， Bieneman BK， Bilgin M， et al. Magnetic resonance imaging in pancreatitis[J]. Top Magn Reson Imaging， 2009， 20(1)：25-30.
27.	Bilgin M， Bilgin S， Balci NC， et al. Magnetic resonance imagingand magnetic resonance cholangiopancreatography findings compared with fecal elastase 1 measurement for the diagnosis of chronic pancreatitis[J]. Pancreas， 2008， 36(1)：e33-e39.
28.	Sugiyama M， Haradome H， Atomi Y. Magnetic resonanceimaging for diagnosing chronic pancreatitis[J]. J Gastroenterol， 2007， 42 Suppl 17：108-112.
29.	Zuccaro P， Stevens T， Repas K， et al. Magnetic resonance cholangiopancreatography reports in the evaluation of chronic pancreatitis：a need for quality improvement[J]. Pancreatology， 2009， 9(6)：764-769.
30.	Sainani NI， Conwell DL. Secretin-enhanced MRCP：proceed with cautious optimism[J]. Am J Gastroenterol， 2009， 104(7)：1787-1789.

1. Forsmark CE. The early diagnosis of chronic pancreatitis[J]. Clin Gastroenterol Hepatol， 2008， 6(12)：1291-1293.
2. Czakó L. Diagnosis of early-stage chronic pancreatitis by secretin-enhanced magnetic resonance cholangiopancreatography[J]. J Gastroenterol， 2007， 42 Suppl 17：113-117.
3. Stevens T， Conwell DL， Zuccaro G. Pathogenesis of chronic pancreatitis：an evidence-based review of past theories and recent developments[J]. Am J Gastroenterol， 2004， 99(11)：2256-2270.
4. Etemad B， Whitcomb DC. Chronic pancreatitis：diagnosis， classification， and new genetic developments[J]. Gastroenterology， 2001， 120(3)：682-707.
5. Steer ML， Waxman I， Freedman S. Chronic pancreatitis[J]. N Engl J Med， 1995， 332(22)：1482-1490.
6. Tamura R， Ishibashi T， Takahashi S. Chronic pancreatitis：MRCP versus ERCP for quantitative caliber measurement and qualitative evaluation[J]. Radiology， 2006， 238(3)：920-928.
7. Coakley FV， Schwartz LH. Magnetic resonance cholangiopancreatography[J]. J Magn Reson Imaging， 1999， 9(2)：157–162.
8. Takehara Y. Can MRCP replace ERCP?[J]. J Magn Reson Imaging， 1998， 8(3)：517-534.
9. Matos C， Metens T， Devière J， et al. Pancreatic duct：morphologic and functional evaluation with dynamic MR pancreatography after secretin stimulation[J]. Radiology， 1997， 203(2)：435-441.
10. Cappeliez O， Delhaye M， Devière J， et al. Chronic pancreatitis：evaluation of pancreatic exocrine function with MR pancreatography after secretin stimulation[J]. Radiology， 2000， 215(2)：358-364.
11. Balci NC， Smith A， Momtahen AJ， et al. MRI and S-MRCP findings in patients with suspected chronic pancreatitis：correlation with endoscopic pancreatic function testing (ePFT)[J]. J Magn Reson Imaging， 2010， 31(3)：601-606.
12. Schneider AR， Hammerstingl R， Heller M， et al. Does secretin-stimulated MRCP predict exocrine pancreatic insufficiency? A comparison with noninvasive exocrine pancreatic function tests[J]. J Clin Gastroenterol， 2006， 40(9)：851-855.
13. Manfredi R， Costamagna G， Brizi MG， et al. Severe chronic pancreatitis versus suspected pancreatic disease：dynamic MR cholangiopancreatography after secretin stimulation[J]. Radiology， 2000， 214(3)：849-855.
14. Sanyal R， Stevens T， Novak E， et al. Secretin-enhanced MRCP：review of technique and application with proposal for quantification of exocrine function[J]. AJR Am J Roentgenol， 2012， 198(1)：124-132.
15. Manfredi R， Perandini S， Mantovani W， et al. Quantitative MRCP assessment of pancreatic exocrine reserve and its correlationwith faecal elastase-1 in patients with chronic pancreatitis[J]. Radiol Med， 2012， 117(2)：282-292.
16. Schlaudraff E， Wagner HJ， Klose KJ， et al. Prospective evaluation of the diagnostic accuracy of secretin-enhanced magnetic resonance cholangiopancreaticography in suspected chronic pancreatitis[J]. Magn Reson Imaging， 2008， 26(10)：1367-1373.
17. Sai JK， Suyama M， Kubokawa Y， et al. Diagnosis of mild chronic pancreatitis (Cambridge classification)：comparative study using secretin injection-magnetic resonance cholangiopancreatography and endoscopic retrograde pancreatography[J]. World J Gastroenterol， 2008， 14(8)：1218-1221.
18. Chopra A， Alkaade S， Balci NC， et al. The effect of prior sphincterotomy on the secretin-stimulated magnetic resonance cholangiopancreatography (s-MRCP)[J]. Acad Radiol， 2009， 16(11)：1381-1385.
19. Erturk SM， Ichikawa T， Motosugi U， et al. Diffusion-weighted MR imaging in the evaluation of pancreatic exocrine function before and after secretin stimulation[J]. Am J Gastroenterol， 2006， 101(1)：133-136.
20. Balc? C. MRI assessment of chronic pancreatitis[J]. DiagnInterv Radiol， 2011， 17(3)：249-254.
21. Akisik MF， Aisen AM， Sandrasegaran K， et al. Assessment of chronic pancreatitis：utility of diffusion-weighted MR imaging with secretin enhancement[J]. Radiology， 2009， 250(1)：103-109.
22. Akisik MF， Sandrasegaran K， Jennings SG， et al. Diagnosis of chronic pancreatitis by using apparent diffusion coefficient measurements at 3.0-T MR following secretin stimulation[J]. Radiology， 2009， 252(2)：418-425.
23. Balci NC， Momtahen AJ， Akduman EI， et al. Diffusion-weightedMRI of the pancreas：correlation with secretin endoscopic pancreatic function test (ePFT)[J]. Acad Radiol， 2008， 15(10)：1264-1268.
24. Balci NC， Alkaade S， Magas L， et al. Suspected chronic pancre-atitis with normal MRCP：findings on MRI in correlation withsecretin MRCP[J]. J Magn Reson Imaging， 2008， 27(1)：125-131.
25. Alkaade S， Cem Balci N， Momtahen AJ， et al. Normal pancreatic exocrine function does not exclude MRI/MRCP chronic pancreatitis findings[J]. J Clin Gastroenterol， 2008， 42(8)：950-955.
26. Balci NC， Bieneman BK， Bilgin M， et al. Magnetic resonance imaging in pancreatitis[J]. Top Magn Reson Imaging， 2009， 20(1)：25-30.
27. Bilgin M， Bilgin S， Balci NC， et al. Magnetic resonance imagingand magnetic resonance cholangiopancreatography findings compared with fecal elastase 1 measurement for the diagnosis of chronic pancreatitis[J]. Pancreas， 2008， 36(1)：e33-e39.
28. Sugiyama M， Haradome H， Atomi Y. Magnetic resonanceimaging for diagnosing chronic pancreatitis[J]. J Gastroenterol， 2007， 42 Suppl 17：108-112.
29. Zuccaro P， Stevens T， Repas K， et al. Magnetic resonance cholangiopancreatography reports in the evaluation of chronic pancreatitis：a need for quality improvement[J]. Pancreatology， 2009， 9(6)：764-769.
30. Sainani NI， Conwell DL. Secretin-enhanced MRCP：proceed with cautious optimism[J]. Am J Gastroenterol， 2009， 104(7)：1787-1789.

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慢性胰腺炎的MRI評價及功能評估

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