双源64层CT血管造影对胰腺癌血管侵犯及可切除性的评估价值

Assessed value of SOMATOM definition flash 64-slice CT angiography for vascular invasion and resectablilty in pancreatic cancer

目的分析双源64层CT血管造影评估胰腺癌血管侵犯及可切除性的临床价值。方法采用双源64层CT术前对23例胰腺癌患者的胰腺癌周围血管受肿瘤侵犯程度及可切除性进行评估,以术中所见及手术结果为"金标准"。结果术前评估161条血管侵犯程度0级97条,1级26条,2级23条,3级10条,4级5条。评估可切除性准确性为98.14%,敏感性99.27%,特异性为91.30%,Kappa值为0.871,ROC曲线下面积为0.878(P均<0.01)。动脉可切除性准确性为98.55%,敏感性100%,特异性为90.91%,Kappa值为0.882,ROC曲线下面积为0.901(P均<0.01)。静脉可切除性准确性为97.83%,敏感性为98.75%,特异性为91.67%,Kappa值为0.865,ROC曲线下面积为0.859(P均<0.01)。结论双源64层CT血管造影评估胰腺癌血管侵犯程度及可切除性有较高准确性、敏感性、特异性,临床诊断与评估价值高。

Objective To analyze the clinical value of SOMATOM definition flash 64-slice CT angiography for vascular invasion and resectablihy in pancreatic cancer. Methods A SOMATOM definition flash 64-slice CT before surgery performed in 23 patients with pancreatic cancer pancreatic angiography, peripheral vascular pancreatic cancer by tumor invasion and resectablihy of the evaluated to intraoperative found and surgical results for ＂ gold standard＂. Results The preoperative assessment of the extent of violations of vascular 161 vein, 0 class were 97 vein, lclass were 26 vein, 2class were 23 vein, 3 class were 10 vein, 4 class were 5 vein. Assess resectability accuracy was 98.14 % ,sensitivity was 99.27% and specificity of was 91.30%, Kappa value was 0.871, the area under the ROC curve was 0.878 （Pall〈 0.01 ）. Arterial resectable accuracy was 98.55%, sensitivity was 100% and specificity was 90.91%, Kappa value was 0.882, the area under the ROC curve was 0.901 （P all 〈 0.01）. Venous resectable accuracy was 97.83%, sensitivity was 98.75%, specificity was 91.67%, Kappa value was 0.865, the area under the ROC curve was 0.859 （P〈0.01）. Conclusion The SOMATOM definition flash 64-slice CT angiography to assess the extent of vascular invasion in pancreatic cancer and a higher resectability accuracy, sensitivity, specificity, clinical diagnosis and evaluation of high value .