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Objective To investigate the role of DWI in differentiating autoimmune pancreatitis ( AIP) from pancreatic cancer ( PC) , and in the therapeutic effect evaluation of AIP.Methods DWI data of 26 cases with AIP , 29 cases with PC and 30 cases with normal pancreas ( NP ) were analyzed retrospectively.The distribution type and signal feature of lesions in cases with AIP or PC were evaluated by Chi-squared test.ADC values were measured and compared among 3 groups by Kruskal-Wallis test.ADC values of AIP and PC were analyzed by using ROC curve to determine the optimal threshold and diagnostic efficiency.ADC values were compared in AIP ( n=15 ) before and after steroid therapy by paired t test.Results Diffuse lesions were detected in 21 cases with AIP and 3 cases with PC, while focal lesions in 5 cases with AIP and 26 cases with PC (χ2 =27.64, P0.05).The median ADC values of AIP, PC and NP were 1.15 ×10 -3,1.35 × 10 -3 ,1.59 ×10-3 mm2/s, respectively; and the difference was statistically significant ( H=45.60, P <0.01).ROC analysis yielded an optimal ADC cutoff value of 1.255 ×10 -3 mm2/s (80.8% sensitivity, 79.3%specificity and 0.871 area under curve for the diagnosis of AIP ).ADC values of AIP ( n=15) were markedly increased from the baseline (1.10 ±0.19) ×10 -3 to (1.57 ±0.12) ×10 -3 mm2/s after steroid therapy (t=-10.14, P<0.01).Conclusions DWI may be useful for diagnosing and evaluating the effect of steroid therapy in AIP.ADC values of AIP were significantly lower than those of pancreatic cancer and normal pancreas.After steroid therapy , ADC values were markedly increased in AIP.
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ncreatic enlargement, MRI is comparable to CT.
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Objective To discuss and analyze the CT appearances and differential diagnosis of pulmonary tuberculomas. Methods 40 cases of pulmonary tuberculomas proved by surgery and pathology were included in the study and compared to 40 cases of peripheral-type bronchogenic carcinomas, which were also surgico-pathologically proved. Results Tuberculomas were most found in the posterior segments of the lung and exhibited well-demarcated lesions of homogeneous density. Some lesions also possessed characteristics like rough spiculation, minute calcification within the lesion and marginal calcification. Thick-walled, thin-walled or stellate cavities were also found. On contrast enhanced scans, tuberculomas showed little or ring enhancement. In addition, satelite lesions or pleural thickening were often found near the tuberculomas. Hilar and mediastinal lymph-nodes were calcified but not enlarged. Anti-tuberbulosis therapy often resulted in little or even no absorption.Conclusion More accurate diagnosis of pulmonary tuberculomas could be made after careful analysis of all CT signs and the clinical data. CT-guided needle biopsy could be used when the dignosis could not be made clearly.