APPLICATION OF MR COMBINED WITH DWI IN THE QUALITATIVE DIAGNOSIS OF PANCREATIC TUMORS

Mei Zhang^1#, Changcheng Li^2#, Bo Han³, Lijun Bai⁴, Jisheng Li⁵, Wenyan Zhang⁶, Xingjun Song⁷, Zhiqiang Liu^8*

¹Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong 271016, China - ²Medical imaging center, Taian city Central Hospital , Taian, Shandong 271099, China - ³Department of Radiology, Weihai Third Hospital of Shandong Province, Weihai, Shandong 264200, China - ⁴Department of Geriatrics, Penglai Hospital of Traditional Chinese medicine, Yantai City, Shandong Province, Yantai, Shandong 265699, China - ⁵Department of Imaging, Penglai Hospital of Traditional Chinese medicine, Yantai City, Shandong Province, Yantai, Shandong 265699, China - ⁶Gynecology department, The 960th Hospital of PLA joint logistics Support Force,Taian, Shandong 271000, China - ⁷Department of Imaging, The Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong 271001, China - ⁸Department of medical imaging, Laizhou people's Hospital, Laizhou, Shandong 261400, China

Objective: This study aims to investigate the application value of magnetic resonance (MR) combined with diffusion-weighted imaging (DWI) in the qualitative diagnosis of pancreatic tumors. 

Methods: Seventy-six patients with pancreatic tumors referred to our hospital from January 2019 to December 2020 were selected for the study. All patients underwent MR and DWI examinations; further, the sensitivity, specificity, accuracy, malignant predictive value, and benign predictive value of MR and DWI examinations alone and in combination were analyzed using the results of puncture biopsy as the "gold standard." 

Results: According to the results of the puncture biopsy, 34 of 76 pancreatic tumor patients enrolled were diagnosed as malignant (44.74%), and 42 were benign (55.26%). The accuracy (94.74%), sensitivity (94.12%), specificity (95. 24%), malignant predictive value (94. 12%), and benign predictive value (95. 24%) of the combined MR and DWI examination were higher than those of MR (88.16%, 88.24%, 88.10%, 85.71%, 90.24%) and DWI (81.58%, 82.35%, 80. 95%, 77. 78%, 85. 00%) examinations alone. There was a definitive agreement between MR diagnosis and puncture biopsy findings (Kappa = 0.630), excellent agreement between DWI diagnosis and puncture biopsy findings (Kappa = 0.761), and excellent agreement between combined MR and DWI diagnosis and puncture biopsy findings (Kappa = 0.894). 

Conclusion: The application of MR combined with DWI in the diagnosis of pancreatic tumor patients has high sensitivity, specificity, and accuracy, providing a reliable basis for the early clinical determination of benign and malignant pancreatic tumors and a guiding basis for the formulation of treatment plans for patients, which is worthy of clinical promotion and application.