MRI平扫及MR胰胆管成像对十二指肠乳头腺癌的诊断分析

Diagnostic Analysis of Duodenal Papillary Adenocarcinoma with Nonenhanced MRI and MR Cholangiopancreatography

目的:分析MRI平扫及MR胰胆管成像(MRCP)对十二指肠乳头腺癌的诊断价值。材料与方法:连续纳入2013年01月到2014年12月在西安市中心医院确诊为十二指肠乳头腺癌的病例75例,以病理诊断为金标准,对比分析MRI平扫和MRCP以及两者联合诊断十二指肠乳头腺癌的准确率、漏诊率等。结果:MRI平扫在阳性预测值、阴性预测值、灵敏度、特异性、准确度与MRCP诊断差异均不具有统计学意义(P>0.05);MRI平扫、MRCP的诊断准确率均显著低于两者联合诊断方式,漏诊率及误诊率显著高于联合诊断,且差异均具有统计学意义(P<0.05)。结论:MRI平扫与MRCP联合诊断十二指肠乳头腺癌结果更为明确,能够给临床提供较为可靠的术前诊断,对十二指肠乳头腺癌的手术及其预后效果均有良好的指导意义。

Purpose ： To study the diagnostic values of MRI and MRCP for duodenal papillary adenocarcinoma. Ma- terials and Methods： A total 75 cases of papillary adenoearcinoma of the duodenum in Xi＇ an Central Hospital from 2013 Jan- uary to 2014 December were included in this study, the clinical data were retrospectively analyzed and comparative analysis of MRI, MRCP gold standard test results with the combination of both methods on the diagnosis accurate rate, missed diagnosis rate. Results： The positive predictive value, negative predictive value, sensitivity, specificity and accuracy in MRI and MRCP have little difference and without statistically significant difference （ P 〉 0. 05 ） ; The diagnosis accurate rate in MRI and MRCP were significantly lower than combined two methods , missed diagnosis and misdiagnosis rate was significantly higher than that of the combined method with statistical significance difference （ P 〈 0. 05 ）. Conclusion： The diagnosis re- sult is more clear for duodenal papillary adenocarcinoma by Combined MRI scan and MRCP, which can provide reliable clini- cal diagnosis, preoperativly can give some guidance for surgery and prognosis.