摘要
目的探讨术前X线计算机体层摄影术(CT)与磁共振成像(MRI)检查评估壶腹周围癌(PACs)相邻器官侵犯的临床应用价值。方法采用回顾性描述性研究方法。收集2013年9月至2019年6月南京医科大学附属无锡第二医院收治的81例PACs患者的临床病理资料;男52例,女29例;平均年龄为62岁,年龄范围为41~80岁。观察指标:(1)手术和病理学检查情况。(2)CT与MRI检查评估PACs相邻器官侵犯情况。(3)CT与MRI检查对PACs相邻器官侵犯的一致性评价。(4)PACs相邻器官侵犯辅助及特征影像征象。(5)CT与MRI检查评估PACs相邻器官侵犯的比较。偏态分布的计量资料以M(范围)表示。计数资料以绝对数或百分比表示。组间比较采用Mann-WhitneyU检验。采用受试者工作特征曲线及其曲线下面积检验CT与MRI检查评估PACs相邻器官侵犯的准确性。一致性比较采用κ检验。结果(1)手术和病理学检查情况:81例患者中,76例行胰十二指肠切除术,5例行姑息性胃空肠吻合或胆道引流联合病灶活组织病理学检查,包括胰腺、十二指肠、淋巴结等。81例患者中,胰头癌35例,其中26例有十二指肠侵犯,9例无十二指肠侵犯。23例壶腹癌患者,其中17例有十二指肠侵犯,4例有十二指肠和胰腺侵犯,2例无十二指肠和胰腺侵犯。17例远端胆管癌患者(乳头型4例、管壁浸润型13例),其中8例有胰腺侵犯,1例有十二指肠和胰腺侵犯,8例无十二指肠和胰腺侵犯。8例有胰腺侵犯及1例有十二指肠和胰腺侵犯患者肿瘤病理学类型均为管壁浸润型。6例十二指肠癌患者,其中4例有胰腺侵犯,2例无胰腺侵犯。(2)CT与MRI检查评估PACs相邻器官侵犯情况:81例患者,35例胰头癌CT和MRI检查评估有十二指肠侵犯25例,无十二指肠侵犯10例。23例壶腹癌CT检查评估有十二指肠侵犯17例,有胰腺侵犯1例,有十二指肠和胰腺侵犯4例,无十二指肠和胰腺侵犯1例;MRI检查评估有十二指肠侵�
Objective To investigate the clinical application value of computed tomography(CT)and magnetic resonance imaging(MRI)examination in preoperative evaluation of adjacent organ invasion for periampullary carcinomas(PACs).Methods The retrospective and descriptive study was conducted.The clinicopathological data of 81 patients with PACs who were admitted to the Affiliated Wuxi No.2 People′s Hospital of Nanjing Medical University from September 2013 to June 2019 were collected.There were 52 males and 29 females,aged from 41 to 80 years,with an average age of 62 years.Observation indicators:(1)surgical and pathological outcomes;(2)evaluation of adjacent organ invasion on CT and MRI examination for PACs;(3)comparison of diagnostic accuracy between CT and MRI examination in assessing adjacent organ invasion for PACs;(4)auxiliary and feature images of adjacent organ invasion for PACs;(5)comparison between CT and MRI examination in assessing adjacent organ invasion for PACs.Measurement data with skewed distribution were represented as M(range),and count data were described as absolute numbers or percentages.Comparison between groups was analyzed using the Mann-Whitney U test.The receiver operating characteristic curve and area under curve were used to evaluate diagnostic accuracy between CT and MRI examination in assessing adjacent organ invasion for PACs.Consistency was compared using theκtest.Results (1)Surgical and pathological outcomes:of the 81 patients,76 underwent pancreatoduodenectomy,5 underwent palliative gastrojejunostomy or biliary drainage combined with biopsy,including the pancreas,duodenum,or lymph nodes.Of the 81 patients,35 had pancreatic head carcinoma including 26 with duodenal invasion and 9 without duodenal invasion;23 had ampullary carcinoma including 17 with duodenal invasion,4 with both duodenal invasion and pancreatic invasion,and 2 without duodenal invasion or pancreatic invasion;17 had distal bile duct carcinoma(including papillary type in 4 patients and periductal infiltrative type in 13 patie
作者
李斌
王均庆
陆风旗
陈昉铭
倪建明
吴文娟
张追阳
金慧涵
唐威
Li Bin;Wang Junqing;Lu Fengqi;Chen Fangming;Ni Jianming;Wu Wenjuan;Zhang Zhuiyang;Jin Huihan;Tang Wei(1 Department of Imaging,the Affiliated Wuxi No.2 People’s Hospital o f Nanjing Medical University.,Wuxi 214002,Jiangsu Province,China;Department of Heptobiliary Surgery^the Affiliated Wuxi No.2 People's Hospital of Nanjing Medical University,Wuxi 214002,Jiangsu Province,China;Department of Pathology,the Affiliated Wuxi No.2 People's Hospital of Nanjing Medical University,Wuxi 214002,Jiangsu Province,China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2020年第3期336-344,共9页
Chinese Journal of Digestive Surgery
基金
无锡市科学技术局医疗与公众健康技术创新应用项目(WX18IIAN023)。
关键词
壶腹周围肿瘤
相邻器官
侵犯
断层摄影
X线计算机
磁共振成像
评价
Periampullary carcinoma
Adjacent organ
Invasion
Computed tomography,X-ray
Magnetic resonance imaging
Evaluation
