多层螺旋CT与MRI扫描鉴别诊断胰腺癌和胰腺炎的有效性探讨

The effectiveness of multislice spiral CT and MRI in differential diagnosis of pancreatic cancer and pancreatitis

目的:探讨多层螺旋CT(MSCT)与MRI扫描对胰腺癌和胰腺炎的鉴别诊断价值。方法:选取2021年12月—2023年12月德州市中医院收治的50例胰腺癌患者和50例胰腺炎患者作为本次研究的观察对象,均行MSCT、MRI扫描,以临床病理结果作为金标准,分析其鉴别诊断价值。结果:MSCT、MRI对胰腺癌和胰腺炎的诊断准确率低于MSCT与MRI的联合检查,差异有统计学意义(P<0.05);而MSCT与MRI诊断的准确率,差异无统计学意义(P>0.05)。胰腺癌在不同扫描时期的CT值低于胰腺炎,差异有统计学意义(P<0.05)。分析比较胰腺癌和胰腺炎的影像学特征,显示胰腺癌在胰腺体积增大、周围淋巴结肿大、病变侵犯周围组织以及大血管上占比高于胰腺炎,其在胰胆管不规则扩张、动脉期强化、病灶内钙化、周围囊肿侵犯上低于胰腺炎,差异有统计学意义(P<0.05)。结论:MSCT、MRI联合诊断胰腺癌和胰腺炎,相较单一检查准确率更高,并可通过胰腺体积、周围淋巴结等影像学特征以及不同扫描分期的CT值进行鉴别诊断。

Objective To explore the value of multislice spiral CT(MSCT)and MRI scanning in the differential diagnosis of pancreatic cancer and pancreatitis.Methods A total of 50 patients with pancreatic cancer and 50 patients with pancreatitis admitted to Dezhou Traditional Chinese Medicine Hospital from December 2021 to December 2023 were selected as the observation subjects of this study.All patients underwent MSCT and MRI scans,and the clinical pathological results were used as the gold standard to analyze their differential diagnostic value.Results The diagnostic accuracy of MSCT and MRI for pancreatic cancer and pancreatitis was lower than that of the combined examination of MSCT and MRI,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference in the diagnostic accuracy between MSCT and MRI(P>0.05).The CT value of pancreatic cancer at different scanning periods was lower than that of pancreatitis,the difference was statistically significant(P<0.05).Analysis and comparison of the imaging features of pancreatic cancer and pancreatitis showed that pancreatic cancer had a higher proportion of enlarged pancreatic volume,enlarged surrounding lymph nodes,lesions invading surrounding tissues and large blood vessels than pancreatitis,and had a lower proportion of irregular dilatation of the pancreaticobiliary duct,arterial phase enhancement,calcification in the lesion,and invasion of surrounding cysts than pancreatitis,and the difference was statistically significant(P<0.05).Conclusion The combined diagnosis of pancreatic cancer and pancreatitis by MSCT and MRI has a higher accuracy rate than that of a single examination,and can perform differential diagnosis through imaging features such as pancreatic volume,surrounding lymph nodes,and CT values at different scanning stages.