CT增强程度对胰腺癌和炎性胰腺肿块的鉴别诊断价值

Value of CT enhancement degree in differential diagnosis between pancreatic carcinoma and inflammatory pancreatic mass

目的比较胰腺癌和炎性胰腺肿块的 CT 增强程度,研究胰腺各期的 CT 强化程度对该两种疾病的诊断价值。方法南京军区南京总医院85例胰腺癌和炎性胰腺肿块患者行平扫、胰期和延迟期增强扫描,测量胰腺肿块和正常胰腺组织的 CT 值,并进行统计学分析。结果 85例患者,胰腺癌66例,炎性胰腺肿块19例。在 CT 平扫、胰期增强、延迟期增强中,胰腺癌组肿块的 CT 值(HU)分别为34±7、54±10、61±14,其相对正常胰腺组织的 CT 值分别是42±6、105±12、77±10;炎性胰腺肿块的 CT 值分别是37±6、58±17、64±10,其相对正常胰腺组织的 CT 值分别是40±8、85±10、72±9。结论胰腺癌肿块和炎性胰腺肿块胰期增强 CT 值对两者的鉴别有一定局限;胰腺癌组和炎性胰腺肿块组肿块以外相对正常胰腺组织的胰期增强程度,前者强化明显,后者则强化中等。

Objective To compare the CT enhancement degree in pancreatic carcinoma （PC） and inflammatory pancreatic mass （IPM）, and to study the diagnostic value of CT to these two diseases. Methods Eighty-five patients with PC or IPM, 47 males and 38 females, aged 62 （37-79）, underwent plain CT scanning and enhanced CT scanning in pancreatic phase and delay phase. The CT values of the pancreatic mass and relative normal pancreatic tissue were measured. The diagnosis of PC and IPM was verified by operation, biopsy, etc. Sixty persons without pancreatic diseases were used as controls. Results Among the 85 patients, 66 were proved to be with PC,and 19 patients were proved to be with IPM. In plain CT scanning, pancreatic-phase CT enhancement, and delay-phase CT enhancement, the CT values of PC were（34±7） HU, （54 ± 10） HU, and （61 ± 14） HU respectively; and the CT values of the relatively normal pancreatic tissue were （42 ± 6） HU, （ 105 ± 12） HU, and （77 ± 10） HU respectively. In plain CT scanning, pancreatic-phase CT enhancement, and delay-phase CT enhancement, the CT values of IPM were （37±6） HU, （58 ± 17） HU, and （64 ± 10） HU respectively; and the CT values of the relatively normal pancreatic tissue were （40±8） HU, （85±10） HU, and （72±9） HU respectively. The pancreatic-phase enhanced CT values of the mass in the PC group and the IPM group showed no remarkable differences （P 〉 0.05）. The pancreatic-phase enhancement intensity of the relatively normal pancreatic tissue is greater in PC than in IPM （P 〈 0.01 ）. Conclusion There is a certain limit for CT enhancement in differentiating between PC and IPM. Comprehensive analysis is necessary in diagnosis of PC and IPM.