多层螺旋CT与单层螺旋CT诊断胰腺癌侵犯胰周血管的比较分析研究

Comparision and Analysis of Peripancreatic Vascular Invasion in Pancreatic Adenocarcinoma Diagnosed with Multislice Spiral CT and Singleslice Spiral CT

目的 比较分析多层螺旋CT(MSCT)与单层螺旋CT(SSCT)对胰腺癌侵犯胰周血管的判断准确性。方法 85例手术病理证实为胰腺导管细胞癌患者 ,术前随机行SSCT(n =4 9)与MSCT(n =36 )胰腺检查。术中由手术者仔细探查胰周主要血管。结果 MSCT与SSCT判断胰腺癌侵犯胰周血管的敏感性分别为 80 .5 % (33/ 4 1)及 5 5 % (2 2 / 4 0 ) ,特异性分别为 95 .7% (111/ 116 )及 95 .1% (117/ 12 3)。MSCT与SSCT对胰腺癌手术可切除性判断的准确性分别为 10 0 % (10 / 10 )及 92 .7% (13/ 14 ) ,对胰腺癌手术不可切除性判断的准确性分别为 84 .6 % (2 2 / 2 6 )及 77.1% (2 7/ 35 )。结论 MSCT胰腺检查诊断胰腺癌侵犯胰周血管的准确性较SSCT高。

Objective To compare and analyze the accuracy of peripancreatic vascular invasion in pancreatic adenocarcinoma diagnosed with multislice spiral CT (MSCT) and singleslice spiral CT (SSCT).Methods Eighty-five patients of pancreatic adenocarcinoma confirmed by surgeco-pathology were preoperatively studied by SSCT ( n =49) and MSCT ( n =36) randomly. The peripancreatic major vessels were investigated carefully by surgeons during operation.Results The sensitivity of peripancreatic vascular invasion judged by MSCT and SSCT was 80.5% (33/41) and 55% (22/40) respectively. The specificity was 95.7% (111/116) for MSCT and 95.1% (117/123) for SSCT respectively. The accuracy of resectability of pancreatic carcinoma was 100% (10/10) for MSCT and 92.7% (13/14) for SSCT respectively. That of unresectability was 84.6% (22/26) for MSCT and 77.1% (27/35) for SSCT respectively.Conclusion MSCT was better than SSCT in determining the accuracy of peripancreatic vascular invasion by pancreatic carcinoma.