PET/CT、MRI及联合应用在胰腺良恶性病变鉴别诊断中的临床价值

Evaluation of clinical value of PET/CT and MRI and combination in differential diagnosis of benign and malignant pancreatic lesions

目的探讨正电子发射体层摄影/计算机体层摄影(positron emission tomography/computed tomography,PET/CT)、磁共振成像(magnetic resonance imaging,MRI)及联合应用对胰腺良恶性病变的诊断价值。方法回顾性分析行PET/CT和MRI的胰腺病变患者(时间间隔≤2周),并以病理或临床影像随访(随访时间≥1年)结果为金标准,统计PET/CT、MRI及两者联合应用对胰腺良恶性病变诊断的灵敏度、特异度、准确度、阳性预测值及阴性预测值。结果 67例患者病理或随访结果显示恶性病灶41例,良性病灶26例,PET/CT的灵敏度、特异度、准确度、阳性预测值及阴性预测值分别为85.37%、80.77%、83.58%、87.50%及77.78%,MRI分别为80.49%、76.92%、79.10%、84.62%及71.43%,PET/CT+MRI分别为90.24%、84.62%、88.06%、90.24%及84.62%。3种方法的诊断准确率比较差异无统计学意义(P>0.05)。结论 PET/CT、MRI对胰腺良恶性病变鉴别均具有较高的诊断价值,必要时两者联合应用可进一步提高对胰腺良恶性病变诊断的准确率。

Objective To evaluate the diagnostic value of positron emission tomography/computed tomography（PET/CT）and magnetic resonance imaging（MRI）and combination of both methods in benign and malignant pancreatic lesions.Methods Retrospective analysis of the patients with pancreatic lesions who had examined PET/CT and MRI（time interval of 2weeks or less）was used in this study.The results were confirmed by pathology or follow-up with clinic imaging（follow-up for 1year or more）,the diagnostic sensitivity,specificity,accuracy,positive and negative predictive value wwere gotten by the statistics of the two methods and their combination in benign and malignant pancreatic lesions.Results In 67 pancreatic lesions,the results of pathology or follow-up were 41 malignant and 26 benign.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value were shown respectively：PET/CT was 85.37%,80.77%,83.58%,87.50% and 77.78%, MRI was 80.49%,76.92%,79.10%,84.62% and 71.43%,PET/CT＋MRI was 90.24%,84.62%,88.06%,90.24% and84.62%.There was no significant difference in diagnostic accuracy between the 3 methods（P〉0.05）.Conclusion PET/CT and MRI has high diagnostic value in differentiating benign and malignant lesions of the pancreas.If necessary,both of them can improve the accuracy of diagnosis of benign and malignant pancreatic diseases.