64排螺旋CT血管成像对胰腺癌血管侵犯的评估  

The evaluation of vascular invasion of pancreatic carcinoma by 64-slice spiral CT

作　　者：荣愈平[1] 黄汉涛[1] 刘家盛[1] 杨勇[1] 罗勋鹏[1] 黎雪琴[2] 

机构地区：[1]武警湖北省总队医院外二科,武汉430061 [2]武警湖北省总队医院放射科,武汉430061

出　　处：《腹部外科》2011年第1期38-40,共3页Journal of Abdominal Surgery

摘　　要：目的探讨64排螺旋CT血管成像在胰腺癌血管侵犯程度及胰腺癌可切除性评估中的价值。方法对28例胰腺癌病人进行腹部螺旋CT检查，并做二维、三维重建图像。分别按照Loyer分型标准、Lu分级标准及本研究制定的标准评价胰腺周围重要血管的侵犯程度，评价胰腺癌是否可切除。以手术结果为金标准，计算各标准对血管可切除性评价的正确率、敏感性、特异性、阳性预测值及阴性预测值，并计算Kappa系数。结果Loyer分型标准判断肿瘤可切除性的正确率、敏感性、特异性、阳性预测值、阴性预测值分别为87．14％、88．00％、86．96％、59．46％和97．09％，其Kappa系数为0．629；Lu分级法分别为92．86％、84．00％、94．78％、77．78％和96．46％，Kappa系数为0．766；本研究标准分别为95．00％、84．00％、97．39％、87．50％和96．55％，Kappa系数为0．827。结论64排螺旋CT血管造影能直观、准确地显示胰腺癌对胰周血管的侵犯，术前64排螺旋CT多期增强扫描判断胰腺癌的胰周血管是否受侵对手术具有前瞻性指导意义。Objective To study the applied value of multi-slice spiral CT angiography（MSCTA） in the preoperative assessment of the vascular invasion degree and resectability in patients with pancreatic carcinoma. Methods Twenty-eight patients with pancreatic cancer were subjected to spiral CT examination in 2D and 3D image reconstructions. The vascular invasion degrees of important vessels around the pancreas were evaluated in accordance with Loyer classification standard, Lu classification standard and the standard made in this study, to figure out whether the pancreatic carcinoma was resected. By using the surgical results as the goldstandard, statistics was taken on the accuracy of the evaluation of each vessel;and the correctness, sensitivity, specificity, positive predictive value and negative predictive value of the evaluations of resectability with different standards. The Kappa coefficients were calculated. Results According to Loyer classification standard,the correctness,sensitivity,specificity, positive predictive value and negative predictive value of the resectability of tumor were 87. 14 %,88. 00 %, 86. 96 %, 59. 46 % and 97. 09 % respectively, with the Kappa coefficient being 0. 629. According to Lu classification standard, they were 92. 86 %,84. 00 %,94. 78 %,77. 78 % and 96. 46 % respectively,with the Kappa coefficient being 0. 766. According to the standard made in this study, they were 95.00 %, 84. 00 %, 97. 39 %, 87. 50 % and 96. 55 % respectively, with the Kappa coefficient being 0. 827. Conclusion MSCT was more direct-viewing and accurate in assessment of major peripancreatic vessels invaded by pancreatic carcinoma combined with MSCTA. The prediction of peripancreatic vessels invaded with MSCT had prospective guide significance for surgery.

关 键 词：胰腺肿瘤 体层摄影术 螺旋计算机 肿瘤转移 血管 外科手术 评价研究 

分 类 号：R814.22[医药卫生—影像医学与核医学]