MRI与超声造影对胰腺囊性病变的诊断价值比较

Comparison of the Diagnostic Value between MRI and Contrast-enhanced Ultrasonogarphy for Pancreatic Cystic Lesions

目的比较磁共振成像(Magnetic resonance imaging,MRI)与超声造影(Contrast-enhanced ultrasonogarphy,CEUS)对胰腺囊性病变的诊断价值。方法回顾性分析2015年1月-2018年2月在我院经病理组织活检确诊为胰腺囊性病变,且有完整MRI及超声影像资料患者的临床资料及影像学资料,共80例,以病理诊断结果为对照,分别计算MRI及超声造影对胰腺囊性病变的诊断鉴别价值。结果MRI诊断胰腺囊性病变的符合率为82.50%,确诊恶性病变41例,良性25例,其余14例误诊或难以鉴别性质;以恶性病变为阳性、良性为阴性,MRI鉴别胰腺囊性病变良恶性的灵敏度为82.00%、特异度为83.33%、准确率为82.50%、阳性预测值为89.13%、阴性预测值为73.52%、kappa值为0.63;CEUS诊断胰腺囊性病变的符合率为75.00%,确诊恶性病变35例,良性25例,其余20例误诊或难以鉴别性质;以恶性病变为阳性、良性为阴性,CEUS鉴别胰腺囊性病变良恶性的灵敏度为70.00%、特异度为83.33%、准确率为75.00%、阳性预测值为87.25%、阴性预测值为62.50%、kappa值为0.50;两种诊断方式对胰腺囊性病变的诊断鉴别价值无统计学意义(p﹤0.05)。结论超声造影用于胰腺囊性病变的诊断及良恶性鉴别,或可取得与MRI接近的诊断效能,值得临床推介。

Objective To compare the value of magnetic resonance imaging (MRI) and contrast-enhanced ultrasonogarphy (CEUS) in the diagnosis of pancreatic cystic lesions. Methods The clinical data and imaging data of 80 patients with pancreatic cystic lesions confirmed by histopathological biopsy in the hospital from January 2015 to February 2018 and having complete imaging findings of MRI and ultrasound were retrospectively analyzed.The value of MRI and CEUS in the diagnosis of pancreatic cystic lesions was evaluated.Results The coincidence rate of MRI in diagnosing pancreatic cystic lesions was 82.50%.41 cases were diagnosed as malignant lesions,and 25 cases were diagnosed as benign lesions.The other 14 cases were misdiagnosed or difficult to identify.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and kappa value of MRI in the diagnosing benign and malignant pancreatic cystic lesions were 82.00%,83.33%,82.50%,89.13%,73.52% and 0.63 respectively.The coincidence rate of CEUS in diagnosing pancreatic cystic lesions was 75.00%.35 cases were diagnosed as malignant lesions,and 25 cases were diagnosed as benign lesions.The other 20 cases were misdiagnosed or difficult to identify.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and kappa value of CEUS in the diagnosing benign and malignant pancreatic cystic lesions were 70.00%,83.33%,75.00%,87.25%, 62.50% and 0.50 respectively.There was no significant difference between the two diagnostic methods for pancreatic cystic lesions (P<0.05).Conclusion CEUS can be used for the differential diagnosis of benign and malignant pancreatic cystic lesions,and the diagnostic efficiency is close to that of MRI.