CT和MR在小胰腺癌诊断中的经验和不足分析

The Experiences in Diagnosis of Small Pancreatic Carcinoma with CT and MR

目的:总结小胰腺癌CT和MR诊断的经验,评估造成误诊的原因,提高诊断的可靠性。方法:回顾性分析21例3cm以下的胰腺癌影像学资料,计算使用不同检查方法时胰腺病灶的对比度,分析误诊的原因。结果:21例中16例初次获得正确诊断,5例误诊。CT动脉期胰腺肿块的对比度最大(C=0.2639),优于静脉期和延迟期(P<0.05);MR的弥散加权图像对比度高于其他序列(C=0.373,P<0.05)。结论:CT上等密度肿块易漏诊;MR DWI对病变的显示和定性有较大价值,联合应用CT和MR有望提高诊断的可靠性。

Purpose：To summarize the experiences in diagnosis of small pancreatic carcinoma with CT and MRI, and to study the causes of misdiagnosis, to improve the reliability of diagnosis. Methods：The CT and/or MR images of 21 patients with pathologically proved pancreatic carcinoma were analyzed retrospectively. The contrast ratio of the tumor lesions was measured and causes of misdiagnosis were analyzed.Results：Sixteen cases（16/21） were diagnosed accurately and 5 cases were misdiagnosed. The contrast ratio of the tumor lesions in CT arterial phase was the highest than that in other phases（C=0.2639, P〈0.05）. Contrast ratio of the tumor lesions in DWI was the highest than that in other sequences（C=0.373, P〈0.05）. Conclusion：The iso-attenuating tumors are more easily misdiagnosed by CT images. DWI of MRI is more valuable in detecting lesions. Combined application of CT and MR may increase the reliability of diagnosis.