增强CT、超声造影和增强MRI对胰腺占位性病变性质的诊断价值比较

Value of enhanced CT,contrast-enhanced ultrasound and enhanced MRI in qualitative diagnosis of pancreatic space-occupying lesions:a comparative study

目的比较增强CT、超声造影和增强MRI对胰腺占位性病变性质的诊断价值。方法回顾性分析80例胰腺占位性病变并行手术治疗患者的临床资料,以及患者术前影像学检查结果。以术后病理检查结果作为“金标准”,比较增强CT、超声造影及增强MRI鉴别胰腺占位性病变良恶性的价值。结果80例患者经病理检查共发现80个病灶,其中18个为良性病变,62个为恶性病变。增强CT诊断胰腺病变良恶性的敏感度、特异度、阳性预测值、阴性预测值分别为89.8%、72.2%、89.8%、72.2%;超声造影的上述四个指标依次为86.8%、71.4%、89.2%、66.7%;增强MRI的上述四个指标依次为82.8%、63.6%、85.7%、58.3%。增强CT、超声造影和增强MRI对胰腺占位性病变良恶性的诊断效能差异无统计学意义(P>0.05)。采用超声造影联合增强CT或增强MRI诊断胰腺占位性病变性质的受试者工作特征曲线下面积大于仅仅应用其中一种检查方法。结论增强CT、超声造影和增强MRI对胰腺占位性病变良恶性的诊断效果相似,采用超声造影联合增强CT或增强MRI有助于提高诊断的准确性。

Objective To compare the value of enhanced CT,contrast-enhanced ultrasound and enhanced MRI in the qualitative diagnosis of pancreatic space-occupying lesions.Methods The clinical data and preoperative radiological examination results of 80 patients with pancreatic space-occupying lesions were retrospectively analyzed.The postoperative pathological examination results were used as the"gold standard",the value of enhanced CT,contrast-enhanced ultrasound and enhanced MRI was compared in differentiating between benign and malignant pancreatic space-occupying lesions.Results A total of 80 lesions were identified by pathological examination in the 80 patients,18 of which were benign and 62 were malignant.In diagnosing benign and malignant pancreatic lesions,sensitivity,specificity,positive predictive value and negative predictive value were 89.8%,72.2%,89.8%and 72.2%for enhanced CT,86.8%,71.4%,89.2%and 66.7%for contrast-enhanced ultrasound,and 82.8%,63.6%,85.7%and 58.3%for enhanced MRI,respectively.There was no significant difference among enhanced CT,contrast-enhanced ultrasound and enhanced MRI in diagnostic efficiency for benign and malignant pancreatic space-occupying lesions(P>0.05).For the qualitative diagnosis of pancreatic space-occupying lesions,the area under the receiver operating characteristic curve of contrast-enhanced ultrasound in a combination with enhanced CT or enhanced MRI was greater than that of any examination method alone.Conclusion Enhanced CT,contrast-enhanced ultrasound and enhanced MRI have similar diagnostic efficiency for benign and malignant pancreatic space-occupying lesions,but contrast-enhanced ultrasound combined with enhanced CT or enhanced MRI is conducive to the improvement of diagnostic accuracy.