摘要
目的:探讨CT增强扫描在肿块型胰腺炎(MFCP)与胰腺导管腺癌(PDAC)鉴别诊断中的价值。方法:选取2019年1月—2023年2月我院收治的MFCP患者24例,PDAC患者38例。分析两种病变的临床资料和CT表现,包括肿瘤部位、边缘、主胰管扩张、胆管扩张、血管侵犯、囊性坏死、胰腺萎缩、钙化、胰管结石、肿瘤/胰腺强化比等,对两种病变进行鉴别诊断,观察两种病变鉴别诊断的结果。结果:胰腺癌患者平均年龄、黄尿或黄疸患者比例、肝内外胆管扩张、血管侵犯发生率高于慢性肿块型胰腺炎组,腹痛患者比例、胰管结石、胰腺钙化发生率低于肿块型胰腺炎组,差异有统计学意义(P<0.05)。肿块型胰腺炎患者动脉期、门脉期和实质期的肿瘤/胰腺强化比高于对应分期胰腺癌组,差异有统计学意义(P<0.05)。胰腺癌患者动脉期、门静脉期、实质期的肿瘤/胰腺强化比低于平扫期,实质期的肿瘤/胰腺强化高于门脉期,差异有统计学意义(P<0.05)。门脉期肿瘤/胰腺强化比对鉴别肿块型胰腺炎和胰腺癌患者的诊断价值最高,其敏感度、特异度、截断值分别为87.5%、94.7%、0.825。结论:门脉期肿瘤/胰腺强化比对鉴别肿块型胰腺炎和胰腺癌具有较高诊断价值,当门脉期肿瘤/胰腺强化比小于0.825时,需高度警惕胰腺癌。
Objective To investigate the value of contrast-enhanced computed tomography(CT)features in distinguishing mass-forming pancreatitis(MFCP)from pancreatic ductal adenocarcinoma(PDAC).Methods 24 patients with pathologically confirmed MFCP and 38 patients with PDAC in our hospital from January 2019 to February 2023 were included in this study.Clinical data and CT imaging features,including tumor location,margin,main pancreatic duct dilatation,bile duct dilatation,vascular invasion,cystic necrosis,pancreatic atrophy,calcification,pancreatic duct stone,tumor-to-pancreas enhancement ratio of the two lesions were evaluated.Results Age,the incidence of yellow urine or icterus and bile duct dilatation,vascular invasion in PDAC was higher than MFCP,while abdominal pain,pancreatic duct stone,pancreatic calcification were lower(P<0.05).Tumor-to-pancreas enhancement ratio in MFCP was significantly higher than that in PDAC in arterial phase,portal venous phase and parenchymal phase(P<0.05).Tumor-to-pancreas enhancement ratio in arterial phase,portal venous phase and parenchymal phase was significantly higher than that in plain scan in MFCP(P<0.05).Tumor-to-pancreas enhancement ratio in the portal phase has the highest diagnostic value in differentiating MFCP from PDAC,with sensitivity,specificity and a cut-off value of 87.5%,94.7%and 0.825,respectively.Conclusion Tumor-to-pancreas enhancement ratio in the portal phase has a high diagnostic value in differentiating MFCP from PDAC.The PDAC should be highly vigilant when the ratio of tumor/pancreatic enhancement in the portal phase is less than 0.825.
作者
张蕊
田春江
张翔
ZHANG Rui;TIAN Chun-jiang;ZHANG Xiang(Tianjin Nankai Hospital,Tianjin 300100,China)
出处
《中国中西医结合外科杂志》
CAS
2024年第5期711-715,共5页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
关键词
肿块型胰腺炎
胰腺导管腺癌
计算机断层扫描
Mass-forming chronic pancreatitis
pancreatic ductal adenocarcinoma
computed tomography
