胰腺癌手术可切除性的术前CT及MRI评估

Application of CT and MRI in Predicting Resectable Pancreatic Carcinoma

[目的]评价CT和MRI术前判断胰腺癌手术可切除性的应用价值。[方法]回顾性分析经病理证实的40例胰腺癌的CT和MRI征象,包括肿瘤大小、边界、血管侵犯、淋巴结转移及远处转移,并与手术及病理对照。[结果]术前影像学显示肿瘤大小平均4.5cm,边界清晰18例,血管受累不可切除26例,淋巴结转移21例,肝脏转移8例,腹膜及远处转移6例。术前影像学对于血管可切除性、淋巴结转移诊断的灵敏度、特异性、准确率分别为76.9%、40.7%、52.5%和70.0%、65.0%、67.5%。手术可切除组和不可切除组肿瘤大小(P=0.546)和肿瘤边界(P=0.053)没有统计学差异。[结论 ]CT和MRI是评估胰腺癌可切除性的有效方法。

[Purpose] To investigate the application of CT and MRI in predicting resectability of pancreatic adenocarcinoma. [Methods] The CT and MRI findings of 40 patients with pancreatic adenocarcinoma were retrospectively analyzed,including mass diameter,boundary,vessel in- volvement,metastatic lymph nodes and distance metastasis. [Results] The mean diameter of the tumors was 4.5cm. The number of the cases with clear boundary,vessel involvement,metastastic lymph nodes and distance metastasis were 18,26,21,8 and 6 respectively. The sensitivity, speci- ficity and accuracy of vessel involvement, metastatic lymph nodes were 76.9% ,40.7%, 52.5% and 70.0% ,65.0% and 67.5% respectively. No difference was detected between the resectable and unresectabel group in mass diameter（P=0.546） and boundary（P=0.053）. [Conclusion] CT and MRI are effective methods in predicting the resectability of pancreatic carcinoma.