胰腺良恶性肿块的CT与磁共振DWI的鉴别诊断分析

Differential Diagnosis of Benign and Malignant Pancreatic Masses by CT and Magnetic Resonance DWI

目的分析CT、DWI序列在胰腺疾病中的鉴别效果。方法于2018年4月—2019年10月抽取医院收治的疑似肿块型胰腺病变患者80例作为研究对象,所有患者均开展CT增强扫描、磁共振DWI序列检查,以病理结果作为金标准,对比CT增强扫描及磁共振DWI序列对肿块型胰腺炎与胰腺癌的鉴别诊断效果。结果80例疑似患者经病理诊断确诊为肿块型胰腺炎者40例、胰腺癌31例。80例疑似患者经CT增强扫描确诊为肿块型胰腺炎者36例、胰腺癌26例;80例疑似患者经磁共振DWI序列检查确诊为肿块型胰腺炎者38例、胰腺癌29例。磁共振DWI序列和CT增强扫描的灵敏度和特异度差异均无统计学意义,P>0.05,。CT增强扫描在肿块型胰腺炎与胰腺癌鉴别诊断中,病变大小与部位两者相比,差异无统计学意义,P>0.05;而胰腺期CT值相比,两种疾病CT值差异有统计学意义,P<0.05。磁共振DWI序列检查发现,胰腺癌ADC值明显高于肿块型胰腺炎(P<0.05)。结论在肿块型胰腺炎与胰腺癌鉴别诊断中,CT增强扫描、磁共振DWI序列均具有一定的诊断价值,各有优势,均可有效对肿块型胰腺炎、胰腺癌进行鉴别诊断。

Objective To analyze the identification effect of CT and DWI sequences in pancreatic diseases.Methods From April 2018 to October 2019,80 patients with suspected mass pancreatic disease were selected as the research objects.All patients were performed CT enhanced scan and magnetic resonance DWI sequence examination.The pathological results were taken as the gold standard,and the differential diagnosis effect of CT enhanced scan and magnetic resonance DWI sequence on mass pancreatitis and pancreatic cancer was compared.Results 80 suspected patients were diagnosed as mass pancreatitis in 40 cases and pancreatic cancer in 31 cases.There were 36 cases of mass pancreatitis and 26 cases of pancreatic cancer in 80 suspected patients,38 cases of mass pancreatitis and 29 cases of pancreatic cancer in 80 suspected patients.There was no significant difference in sensitivity and specificity between magnetic resonance DWI sequence and enhanced CT scan(P>0.05).In the differential diagnosis of mass pancreatitis and pancreatic cancer,there was no difference between the size and location of the lesions(P>0.05),but there was statistical significance between the two diseases(P<0.05).The ADC value of pancreatic cancer was significantly higher than that of mass pancreatitis(P<0.05).Conclusion In the differential diagnosis of mass pancreatitis and pancreatic cancer,CT enhanced scan and magnetic resonance DWI sequence have certain diagnostic value,each has its own advantages,and can effectively differentiate mass pancreatitis and pancreatic cancer.