能谱CT血管造影对壶腹部周围癌及术前分期的诊断价值研究  

Diagnostic value of spectrum CT angiography in periampullary carcinoma and preoperative staging

作　　者：陈亮[1] 傅志颖 胡含明[1] 巫启恒 刘霞[1] 王小方[1] CHEN Liang;FU Zhiying;Hu Hanming;WU Qiheng;LIU Xia;WANG Xiaofang(Department of Imaging,Pingxiang People′s Hospital,Jiangxi Province,Pingxiang 337000,China)

机构地区：[1]江西省萍乡市人民医院影像科,江西萍乡337000

出　　处：《中国当代医药》2022年第7期104-106,110,共4页China Modern Medicine

基　　金：江西省萍乡市科技计划项目(2019PY046)。

摘　　要：目的探讨能谱CT血管造影对壶腹部周围癌诊断及术前分期的评估价值。方法选取2016年7月至2020年12月江西省萍乡市人民医院收治的60例疑似壶腹部周围肿瘤患者作为研究对象,术前进行常规CT增强扫描与能谱CT血管造影检测,并以手术或活检病理结果为金标准,分析能谱CT血管造影对疾病诊断与术前分期评估价值。结果44例患者经手术或活检病理证实有壶腹周围癌,16例为壶腹部周围炎性肿块。能谱CT血管造影诊断良恶性病灶敏感度为93.18%,特异度为93.76%,准确度为93.33%,阳性预测值为97.62%,阴性预测值为83.33%,高于常规CT增强扫描的77.27%、62.50%、73.33%、85.00%、50.00%。41例能谱CT血管造影与病理诊断结果一致均为壶腹部周围癌的患者中,病理T分期包括T_(1)期4例,T_(2)期21例,T_(3)期13例,T4期3例;能谱CT血管造影结果显示T_(1)期5例,T_(2)期20例,T_(3)期12例,T4期4例;能谱CT血管造影对壶腹部周围癌分期诊断与病理T_(1)、T_(2)、T_(3)、T4分期结果的Kappa一致性分别为0.626、0.659、0.597、0.532。结论能谱CT血管造影对壶腹部周围癌具有较高的诊断价值,可指导壶腹部周围癌术前T分期。Objective To explore the value of spectral CT angiography in the diagnosis of periampullary carcinoma and its preoperative staging.Methods A total of 60 patients with suspected periampullary carcinoma in Pingxiang People′s Hospital,Jiangxi Province were enrolled between July 2016 and December 2020.All underwent routine enhanced CT scan and spectral CT angiography before surgery.Using the pathological results of surgery or biopsy as the gold standard,the value of energy spectrum CT angiography in diagnosis and preoperative staging was analyzed.Results A total of 44 cases confirmed with periampullary carcinoma by surgery or biopsy,and 16 cases with periampullary inflammatory lumps.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of spectral CT angiography in the diagnosis of benign and malignant lesions were 93.18%,93.76%,93.33%,97.62%and 83.33%,greater than those of routine enhanced CT scan of 77.27%,62.50%,73.33%,85.00%,50.00%.Among the 41 patients confirmed with periampullary carcinoma by both spectral CT angiography and pathological diagnosis,there were 4 cases with T staging at stage T_(1),21 cases at T_(2),13 cases at T_(3) stage and 3 cases at T4.The results of spectral CT angiography showed that there were 5 cases with T staging at stage T_(1),20 cases at T_(2),12 cases at T_(3) stage and 4 cases at T4.The consistency Kappa values between spectral CT angiography and pathological diagnosis for stages T_(1),T_(2),T_(3) and T4 were 0.626,0.659,0.597 and 0.532,respectively.Conclusion The spectral CT angiography is of high diagnostic value for periampullary carcinoma,which can guide preoperative T staging of periampullary carcinoma.

关 键 词：壶腹部周围癌 能谱CT 血管造影 诊断 术前分期 

分 类 号：R735[医药卫生—肿瘤]