磁共振成像与计算机断层扫描在胰腺导管腺癌血管侵犯术前评估中的价值比较  

Comparison of magnetic resonance imaging and computed tomography in the preoperative evaluation of peripancreatic vascular invasion in pancreatic ductal adenocarcinoma

作　　者：佘响云[1] 周小琦 谢定祥 陈笑芳 张印宏 冯仕庭[2] 蔡华崧[2] She Xiangyun;Zhou Xiaoqi;Xie Dingxiang;Chen Xiaofang;Zhang Yinhong;Feng Shiting;Cai Huasong(Department of Radiology,Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518000,China;Department of Radiology,the First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]深圳市中医院放射科,518000 [2]中山大学附属第一医院放射科,广州510080

出　　处：《中华普通外科学文献（电子版）》2024年第2期106-110,共5页Chinese Archives of General Surgery(Electronic Edition)

基　　金：中华国际医学交流基金会2020 SKY影像科研基金科研公益项目(Z-2014-07-2003-07)。

摘　　要：目的对比磁共振成像(MRI)与计算机断层扫描(CT)在诊断胰腺导管腺癌(PDAC)的胰周血管侵犯中的应用价值。方法选择2019年6月至2022年5月中山大学附属第一医院82例经手术切除或开腹探查且病理诊断为PDAC的患者,根据手术结果证实其中发生血管侵犯25例,无血管侵犯57例。患者均进行MRI与CT检查,分别评估两种检查方式对胰周动、静脉侵犯的诊断效能,并对比单用一种检查方式与联合两种检查的评估结果的诊断差异。结果MRI和CT评估静脉侵犯时的敏感度和特异度差异无统计学意义,而MRI对发生静脉侵犯的区分能力优于CT(P<0.05);MRI和CT评估动脉侵犯时的敏感度和判断能力差异无统计学意义,而MRI特异度优于CT(P<0.001);MRI联合CT后评估的敏感度提高,对血管侵犯的判断能力优于CT(P<0.05)。结论MRI较CT更适用于评估PDAC胰周静脉侵犯,MRI联合CT可以提高对PDAC血管侵犯的诊断敏感度。Objective To compare the value of magnetic resonance imaging(MRI)and computed tomography(CT)in the diagnosis of peripancreatic vascular invasion in pancreatic ductal adenocarcinoma(PDAC).Methods Eighty-two patients with PDAC diagnosed pathologically by surgical resection or laparotomy in the First Affiliated Hospital of Sun Yat-sen University from June 2019 to May 2022 were selected.Among them,25 cases with vascular invasion and 57 cases without vascular invasion were confirmed according to the surgical results.All patients were examined by MRI and CT.The diagnostic efficacy of the two modalities for peripancreatic arterial and venous invasion was evaluated separately.The diagnostic differences between the results of one modality alone and the combination of the two modalities were compared.Results The differences in sensitivity and specificity between MRI and CT in assessing venous invasion were not statistically significant,while the aera under the curve(AUC)of MRI was better than CT(P<0.05);the differences in sensitivity and judgment between MRI and CT in assessing arterial invasion were not statistically significant,while the specificity of MRI was better than that of CT(P<0.001).When MRI was combined with CT,the sensitivity of assessment was increased and the judgment ability of vascular invasion was better than CT(P<0.05).Conclusion MRI is more suitable than CT for assessing peripancreatic venous invasion in PDAC,and combination of MRI with CT can improve the diagnostic sensitivity of vascular invasion in PDAC.

关 键 词：癌 胰腺管 磁共振成像 体层摄影术 X线计算机 胰周血管侵犯 

分 类 号：R735.9[医药卫生—肿瘤]