摘要
目的比较胰腺癌（PC）和炎性胰腺肿块（IPM）的各种CT征象，探讨各种CT征象对该2种病变的诊断价值。方法回顾性分析85例经手术病理、细针穿刺活检及综合手段证实的PC和IPM患者资料，85例均行CT平扫和增强扫描，采用Fisher精确概率检验比较各种CT征象在2种病变中的发生率，并和病理、临床结果进行对照分析。结果85例中，66例PC，19例IPM。PC组中，CT正确诊断58例，漏诊5例（漏诊率为7．6％），误诊3例（误诊率为4．5％）。IPM组中，CT正确诊断9例，误诊10例，误诊率为52．6％。各种CT征象中，（1）胰腺肿块合并肝脏转移、胰周腹膜后淋巴结肿大、腹腔动脉干被包绕及门静脉癌栓只出现在PC组中。（2）PC组胰腺肿块直径≥3cm、边界清、肿块内囊状低密度区、假性囊肿、胰周渗出、腹水、胰胆管轻中度扩张、重度扩张及双管征的发生率分别为90．91％（60／66）、15．15％（10／66）、54．55％（36／66）、10．61％（7／66）、4．55％（3／66）、22．73％（15／66）、24．24％（16／66）、45．45％（30／66）和27．27％（18／66），IPM组分别为94．74％（18／19）、15．79％（3／19）、52．63％（10／19）、15．79％（3／19）、15．79％（3／19）、21．05％（4／19）、31．58％（6／19）、21．05％（4／19）和5．26％（1／19），差异均无统计学意义（P〉0．05）。（3）PC组胰头体部肿块合并胰腺体尾萎缩、胰腺肿块的钙化、扩张的胰管穿过胰腺肿块、胰头肿块合并体尾部肿胀、胆系结石和炎症、肾前筋膜增厚的发生率分别为48．48％（32／66）、3．03％（2／66）、1．52％（1／66）、10．61％（7／66）、6．06％（4／66）和3．03％（2／66），IPM组分别为5．26％（1／19）、47．37％（9／19）、15．79％（3／19）、84．21％（16／19）、36．84％（7／19）、21．05％（4／19），差异均有统计学意
Objective To compare various CT signs of pancreatic carcinoma （PC） and inflammatory pancreatic mass （IPM） , and to study the diagnostic value of these signs for distinguishing two diseases. Methods Eigty-five patients with PC and IPM were proved by surgery, fine needle aspiration or other comprehensive methods. These patients underwent non-enhanced and enhanced CT scans. CT findings were analyzed retrospectively. The occurrance rates of various CT signs in these two diseases were analyzed with Fisher test and were compared with the corresponding clinical and operational results as well. Results Among the 85 patients, 66 patients were proved to have PC, and 19 were proved to have IPM. In PC group, 58 were eorerectly diagnosed with CT, 3 （4. 5% ） were misdiagnosed, and 5 （7.6%） were omitted. In IPM group, 9 were correctly diagnosed with CT and 10 （52. 6% ） were misdiagnosed. The CT findings were as follows： （1） Pancreatic mass with liver metastases, lymph node metastases, encased celiac arteries, and cancer emboli in portal veins just occurred in PC group. （2） The occurrence rates of mass over 3 cm in diameter, clear boundary, low-density area within the mass, pseudoeysts, peripancreatic infiltration, ascites, and slight and moderate pancreatic-bile duct dilation in PC group were 90. 91% （60/66） , 15. 15% （ 10/66）, 54. 55% （ 36/66 ）, 10. 61% （ 7/66 ）, 4. 55% （ 3/66 ）, 22. 73% （ 15/66 ）, 24. 24% （ 16/66 ）, 45.45% （30/66）, and 27. 27% （18/66）respectively, the occurrence rates in IPM group were 94. 74% （18/19）, 15. 79% （ 3/19 ）, 52. 63% （ 10/19 ）, 15.79% （ 3/19 ）, 15. 79% （ 3/19 ）, 21.05% （4/19）, 31.58% （6/19） ,21.05% （4/19）, and 5.26% （1/19） respectively. There was no statistical difference for these CT findings between two groups （ P 〉 0. 05 ）. （ 3 ） Pancreatic head mass with atrophy of pancreatic body and tail, mass calcification, pancreatic duct-penetrating sign, pancreatic head mass with hypertrophy of
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2009年第6期621-624,共4页
Chinese Journal of Radiology
基金
国家自然科学基金资助项目（30870689）
江苏省六大高峰人才资助项目（07-B-046）
江苏省自然科学基金资助项目（BK2008325）
