磁共振成像与计算机断层扫描在胰腺导管腺癌血管侵犯术前评估中的价值比较
Comparison of magnetic resonance imaging and computed tomography in the preoperative evaluation of peripancreatic vascular invasion in pancreatic ductal adenocarcinoma
佘响云 1周小琦 2谢定祥 2陈笑芳 2张印宏 2冯仕庭 2蔡华崧2
作者信息
- 1. 518000 深圳市中医院放射科
- 2. 510080 广州,中山大学附属第一医院放射科
- 折叠
摘要
目的 对比磁共振成像(MRI)与计算机断层扫描(CT)在诊断胰腺导管腺癌(PDAC)的胰周血管侵犯中的应用价值.方法 选择 2019 年 6 月至 2022 年 5 月中山大学附属第一医院 82例经手术切除或开腹探查且病理诊断为PDAC的患者,根据手术结果证实其中发生血管侵犯25例,无血管侵犯 57 例.患者均进行MRI与CT检查,分别评估两种检查方式对胰周动、静脉侵犯的诊断效能,并对比单用一种检查方式与联合两种检查的评估结果的诊断差异.结果 MRI和CT评估静脉侵犯时的敏感度和特异度差异无统计学意义,而MRI对发生静脉侵犯的区分能力优于CT(P<0.05);MRI和CT评估动脉侵犯时的敏感度和判断能力差异无统计学意义,而MRI特异度优于CT(P<0.001);MRI联合CT后评估的敏感度提高,对血管侵犯的判断能力优于CT(P<0.05).结论 MRI较CT更适用于评估PDAC胰周静脉侵犯,MRI联合CT可以提高对PDAC血管侵犯的诊断敏感度.
Abstract
Objective To compare the value of magnetic resonance imaging(MRI)and computed tomography(CT)in the diagnosis of peripancreatic vascular invasion in pancreatic ductal adenocarcinoma(PDAC).Methods Eighty-two patients with PDAC diagnosed pathologically by surgical resection or laparotomy in the First Affiliated Hospital of Sun Yat-sen University from June 2019 to May 2022 were selected.Among them,25 cases with vascular invasion and 57 cases without vascular invasion were confirmed according to the surgical results.All patients were examined by MRI and CT.The diagnostic efficacy of the two modalities for peripancreatic arterial and venous invasion was evaluated separately.The diagnostic differences between the results of one modality alone and the combination of the two modalities were compared.Results The differences in sensitivity and specificity between MRI and CT in assessing venous invasion were not statistically significant,while the aera under the curve(AUC)of MRI was better than CT(P<0.05);the differences in sensitivity and judgment between MRI and CT in assessing arterial invasion were not statistically significant,while the specificity of MRI was better than that of CT(P<0.001).When MRI was combined with CT,the sensitivity of assessment was increased and the judgment ability of vascular invasion was better than CT(P<0.05).Conclusion MRI is more suitable than CT for assessing peripancreatic venous invasion in PDAC,and combination of MRI with CT can improve the diagnostic sensitivity of vascular invasion in PDAC.
关键词
癌,胰腺管/磁共振成像/体层摄影术,X线计算机/胰周血管侵犯Key words
Carcinoma,pancreatic ductal/Magnetic resonance imaging/Tomography,X-Ray computed/Peripancreatic vascular invasion引用本文复制引用
基金项目
中华国际医学交流基金会SKY影像科研基金科研公益项目(2020)(Z-2014-07-2003-07)
出版年
2024
NETL
NSTL
万方数据