摘要目的:分析MRI结合DWI检查在评估急性胰腺炎（AP）患者病情严重程度中的应用价值。方法:选取2018年1月至2020年3月烟台市烟台山医院收治的113例AP患者作为观察组，根据Balthazar评分分为轻度组和重度组；另选取50例非AP患者作为对照组。所有受试者行MRI结合DWI检查，比较两组检查水分子扩散异质性指数（α）值、拉伸指数模型参数扩散分布系数（DDC）、单指数模型参数标准ADC（Standard ADC）、快速扩散ADC分数（Ft ADC）等指标；绘制ROC曲线分析MRI及DWI单独及联合应用的诊断评估价值。结果:观察组α值高于对照组，DDC、Standard ADC及Ft ADC值均低于对照组（ P<0.05）；重度组α值、Balthazar评分高于轻度组，DDC、Standard ADC及Ft ADC值低于轻度组（ P<0.05）。MRI结合DWI评估AP病情严重程度的敏感度、特异度及AUC均高于MRI或DW单独应用（ P<0.05）。 结论:MRI结合DWI检查可准确反应AP病情，较好反应组织异质性，提高诊断价值。

abstractsObjective:To investigate the value of MRI with diffusion-weighted images (DWI) in evaluating the severity of acute pancreatitis (AP) .Methods:A total of 113 AP patients admitted to Yantaishan Hospital of Yantai between January 2018 and March 2020 were included as the study group, and divided into mild and severe sub-groups according to the disease severity. Fifty non-AP patients were included as the control group. All subjects underwent MRI with DWI. ROC curve was generated to assess the diagnostic value of MRI with DWI vs MRI or DWI alone.Results:Compared with the control group, the study group showed higher value of water molecule diffusion heterogeneity index (α) , lower value of distributed diffusion coefficient (DDC) by stretched exponential model, lower values of standard apparent diffusion coefficient (ADC) and fraction of fast-ADC (Ft ADC) by mono-exponential model ( P<0.05) . Compared with the mild subgroup, the severe subgroup had higher α value and MRI Balthazar score, lower values of DDC, Standard ADC and Ft ADC ( P<0.05) . MRI with DWI yielded higher sensitivity, specificity and area under curve (AUC) in assessing the severity of AP compared with MRI or DWI alone ( P<0.05) . Conclusion:MRI with DW may accurately determine the severity of AP and visualize the tissue heterogeneity, and therefore is more diagnostically valuable.