螺旋CT双期增强扫描在早期胰腺癌诊断中的价值分析  

Analysis of the value of dual-phase contrast-enhanced spiral CT in the diagnosis of early-stage pancreatic cancer

作　　者：刘鑫 LIU Xin(Department of Radiology and Imaging,Huludao Central Hospital,Huludao 125000,China)

机构地区：[1]辽宁省葫芦岛市中心医院放射影像科,125000

出　　处：《中国实用医药》2023年第6期73-75,共3页China Practical Medicine

摘　　要：目的 研究螺旋CT双期增强扫描在早期胰腺癌诊断中的价值。方法 回顾性分析80例疑似早期胰腺癌患者的临床资料,所有患者入院以后均进行螺旋CT胰腺期和门脉期双期增强扫描。将最终的病理诊断结果作为金标准,分析螺旋CT双期增强扫描的诊断结果、诊断价值及影像学图像。结果 螺旋CT双期增强扫描的检出率为90.00%,与病理诊断的检出率92.50%比较,差异无统计学意义(P>0.05)。螺旋CT双期增强扫描诊断早期胰腺癌的阳性预测值、阴性预测值、敏感度、特异度、准确度、约登指数、误诊率、漏诊率分别为98.61%、62.50%、95.95%、83.33%、95.00%、0.7928、16.67%、4.05%。患者有典型的影像学图像表现。经过螺旋CT双期增强扫描检出的72例患者中,病灶在胰头部35例,病灶在胰体部和胰尾部37例。胰腺的CT值为(38.45±5.46)Hu,高于肿块的(29.65±3.26)Hu,差异有统计学意义(P<0.05);还有18例患者的肿瘤-胰腺对比CT值在10 Hu之内,主要为等密度且肉眼无法识别的肿块,12例患者合并轻度的胆管、胰腺管扩张。经过增强扫描,肿瘤在胰腺期和门脉期的增强值分别为(33.75±18.15)Hu和(35.84±16.94)Hu,对比差异无统计学意义(P>0.05);正常组织的胰腺期增强值为(73.65±18.44)Hu,高于门脉期的(54.35±12.46)Hu,差异有统计学意义(P<0.05);肿瘤-胰腺对比胰腺期为(45.28±18.04)Hu,高于门脉期的(22.15±12.03)Hu,差异有统计学意义(P<0.05)。结论 螺旋CT双期增强扫描在早期胰腺癌诊断中的应用价值高,可以为临床的诊断和治疗工作提供科学的参考,是一种有价值的诊断手段。Objective To study the value of dual-phase contrast-enhanced spiral CT in the diagnosis of early-stage pancreatic cancer.Methods Clinical data of 80 patients suspected of early stage pancreatic cancer were retrospectively analyzed.All patients received dual-phase contrast-enhanced spiral CT in pancreatic and portal venous phases after admission,and the final pathological results were used as the gold standard to analyze the diagnostic results,diagnostic value and image findings of dual-phase contrast-enhanced spiral CT.Results The detection rate of dual-phase contrast-enhanced spiral CT was 90.00%,which was not statistically significant compared with 92.50%of pathological diagnosis(P>0.05).The positive predictive value,negative predictive value,sensitivity,specificity,accuracy,Youden's index,misdiagnosis rate and missed diagnosis rate of dual-phase contrast-enhanced spiral CT were 98.61%,62.50%,95.95%,83.33%,95.00%,79.28%,16.67%and 4.05%,respectively.The patient had typical imaging findings.Among the 72 patients detected by dual-phase contrastenhanced spiral CT,35 cases had lesions in the head of the pancreas,and 37 cases had lesions in the body and tail of the pancreas.The CT value of pancreas was(38.45±5.46)Hu,which was higher than(29.65±3.26)Hu of mass,and the difference was statistically significant(P<0.05).There were also 18 patients with tumorpancreatic contrast CT values within 10 Hu,which were mainly isointense and unrecognizable masses to the naked eye,and 12 patients combined with mild bile duct and pancreatic duct dilatation.After contrast enhancement,the enhancement values of tumors in the pancreatic and portal venous phases were(33.75±18.15)Hu and(35.84±16.94)Hu,and the difference was not statistically significant(P>0.05).The enhancement value in the pancreatic phase of normal tissue was(73.65±18.44)Hu,which was higher than(54.35±12.46)Hu in the portal phase,and the difference was statistically significant(P<0.05).The CT value of tumor-pancreatic contrast was(45.28±18.04)Hu in the pancreatic p

关 键 词：螺旋CT 双期增强扫描 早期胰腺癌 病理诊断 影像学 

分 类 号：R735.9[医药卫生—肿瘤] R730.44[医药卫生—临床医学]