EUS检查与MRCP成像对IPMN良恶性鉴别诊断效能对比

Comparison on Efficiency between EUS and MRCP Imaging in the Differential Diagnosis of Benign and Malignant IPMN

目的分析内镜超声检查(EUS)检查磁共振胰胆管造影(MRCP)对胰腺导管内乳头状黏液肿瘤(IPMN)良恶性鉴别诊断效能。方法回顾分析本院2016年1月至2019年5月收治的31例IPMN患者的影像学资料,对患者所得EUS和MRCP图像进行分析,对比EUS和MRCP对IPMN良恶性鉴别诊断正确率。结果EUS对IPMN良恶性鉴别诊断正确率分别为83.33%、76.92%,MRCP为88.89%、92.30%,MRCP虽略高于EUS但两者之间比较无差异(P>0.05);良性:EUS肿瘤形态规则,边界清晰,肿瘤最大直径为(28.33±4.26)mm,主胰管最大直径(6.12±2.26)mm,内部结节高度(2.33±1.02)mm;MRCP:可见其T_(1)WI、T_(2)WI多为长信号,肿瘤为多房囊性肿瘤。恶性:EUS肿瘤常为不规则形态,边界不清晰,肿瘤最大直径为(33.26±5.87)mm,主胰管最大直径(13.45±3.58)mm,内部结节高度(7.45±1.88)mm,MRCP:T_(1)WI、T_(2)WI多为长信号,肿瘤为单房囊性肿瘤。结论EUS检查与MRCP成像均可为IPMN良恶性鉴别提供参考依据,在临床实践中医生可根据患者基本情况来选择合适的检查方法。

Objective To analyze the differential diagnosis of magnetic resonance cholangiopancreatography(MRCP)for benign and malignant intraductal papillary mucinous neoplasm(IPMN)by endoscopic ultrasonography(EUS).Methods The imaging data of 31 patients with IPMN treated in our hospital from January 2016 to May 2019 were retrospectively analyzed.The EUS and MRCP images of patients were analyzed,and the accuracy in the differential diagnosis of benign and malignant IPMN was compared between EUS and MRCP.Results The accuracy of EUS in the differential diagnosis of benign and malignant IPMN was 83.33%,76.92%,and accuracy of MRCP was 88.89%,92.30%.Although accuracy of MRCP was slightly higher than that of EUS,there was no difference between the them(P>0.05).Benign:EUS showed that the shape of the tumor was regular,the boundaries were clear,the maximum diameter of the tumor was(28.33±4.26)mm,the maximum diameter of the main pancreatic duct was(6.12±2.26)mm,and the height of the internal nodule was(2.33±1.02)mm.MRCP showed that its T_(1)WI and T_(2)WI were mostly long signals,and the tumors were multilocular cystic tumors.Malignant:EUS showed that the shape of the tumor was often irregular and the border was not clear.The maximum diameter of the tumor was(33.26±5.87)mm,the maximum diameter of the main pancreatic duct was(13.45±3.58)mm,and the height of the internal nodule was(7.45±1.88)mm.MRCP showed that T_(1)WI and T_(2)WI were mostly long signals,and the tumors were unilocular cystic tumors.Conclusion EUS examination and MRCP imaging can provide a reference for the identification of benign and malignant IPMN.In clinic,doctors can choose the appropriate examination method according to the basic situation of the patient.