CT影像特征及纹理分析对胰腺腺泡细胞癌鉴别诊断的价值

Value of computed tomography imaging features and texture analysis in the differential diagnosis of acinar cell carcinoma of the pancreas

目的探讨CT影像特征及纹理分析对胰腺腺泡细胞癌(ACCP)鉴别诊断的价值。方法回顾性分析2017年1月-2018年10月我院病理学诊断为ACCP、胰腺导管腺癌(PDCA)、胰腺实性假乳头状瘤(SPN)患者的临床资料,对其临床表现、肿瘤标志物情况、CT表现及纹理特征参数等进行比较分析。结果5例增强CT影像显示,ACCP病变多呈囊实性密度影,体积较大且实性成分居多;12例PDCA病变CT影像多呈实性密度影,且体积多数较小;12例SPN病变CT影像多呈囊实性密度影,病变体积常大于ACCP,实性成分较少,可出现“浮云征”。8个纹理特征参数对ACCP与PDCA鉴别诊断具有价值(Z=2.015~2.530,P<0.05),4个纹理特征参数对ACCP与SPN鉴别诊断具有价值(Z=2.108~2.864,P<0.05)。结论ACCP的诊断相对困难,CT影像特征及纹理分析有助于诊断并与PDCA及SPN进行鉴别。

Objective To explore the value of computed tomography(CT)imaging features and texture analysis in the differential diagnosis of acinar cell carcinoma of the pancreas(ACCP).Methods The clinical data of patients who were patholo-gically diagnosed with ACCP,pancreatic ductal adenocarcinoma(PDAC),or solid pseudopapillary neoplasm(SPN)of the pancreas in our hospital from January 2017 to October 2018 were retrospectively analyzed.The clinical manifestations,tumor markers,CT imaging features,and texture parameters were compared and analyzed.Results The contrast-enhanced CT images of 5 patients with ACCP showed that most of the lesions were solid-cystic masses with a large size and more solid components.The CT images of 12 patients with PDAC showed that most of the lesions were solid masses with a small size.The CT images of 12 patients with SPN showed that most of the lesions were solid-cystic masses with a size greater than that of ACCP lesions and fewer solid components,showing the“floating cloud sign”.Eight texture parameters were valuable for the differential diagnosis between ACCP and PDAC(Z=2.015-2.530,P<0.05).Four texture parameters were valuable for the differential diagnosis between ACCP and SPN(Z=2.108-2.864,P<0.05).Conclusion The diagnosis of ACCP is relatively difficult.The CT imaging features and texture analysis contribute to the diagnosis of ACCP and its differentiation with PDAC and SPN.