增强CT对胰腺癌的周围血管侵犯的评估价值分析

Value of Enhanced CT in Evaluating Peripheral Vascular Invasion in Patients with Pancreatic Cancer

目的分析增强CT对胰腺癌患者周围血管侵犯的评估价值。方法选取2020年12月至2023年12月于本院接受手术治疗的胰腺癌患者57例作为研究对象,以手术病理检查结果作为“金标准”,收集所有患者术前增强CT资料,评价增强CT对胰腺癌周围血管侵犯的诊断效能。结果57例患者中有42例患者为可切除性胰腺癌,15例患者为不可切除胰腺癌,并经手术评估共有285条周围血管受侵,57条周围血管未受侵。增强CT与手术病理结果相比,增强CT对胰周血管受侵的诊断准确率为93.27%、灵敏度为93.68%、特异度为91.23%、阳性预测值为98.16%、阴性预测值为74.29%,Kappa值为0.778;增强CT对胰周动管受侵的诊断准确率为95.61%、灵敏度为96.43%、特异度为90.63%、阳性预测值为98.44%、阴性预测值为80.56%,Kappa值为0.827;增强CT对胰周静管受侵的诊断准确率为86.84%、灵敏度为86.52%、特异度为88.00%、阳性预测值为96.25%、阴性预测值为64.71%,Kappa值为0.660。结论增强CT术前对胰腺癌周围血管侵犯情况的评估具有较高的诊断价值,可通过术前评估帮助临床诊断肿瘤的可切除性。

Objective To analyze the value of enhanced CT in evaluating peripheral vascular invasion in patients with pancreatic cancer.Methods Fifty-seven patients with pancreatic cancer who underwent surgery in the hospital between December 2020 and December 2023 were selected as the study subjects.Surgical and pathological results were taken as the gold standard.Preoperative enhanced CT data of all patients were collected to evaluate the diagnostic efficacy of enhanced CT for peripheral vascular invasion of pancreatic cancer.Results Among 57 patients,42 patients had resectable pancreatic cancer and 15 patients had unresectable pancreatic cancer.Surgical results showed that a total of 285 peripheral blood vessels were invaded and 57 peripheral blood vessels were not.Compared with surgical and pathological results,the accuracy,sensitivity,specificity,positive predictive value,negative predictive value and Kappa value of enhanced CT for diagnosing peripancreatic vascular invasion were 93.27%,93.68%,91.23%,98.16%,74.29%and 0.778,respectively.The accuracy,sensitivity,specificity,positive predictive value,negative predictive value and Kappa value of enhanced CT for diagnosing peripancreatic artery invasion were 95.61%,96.43%,90.63%,98.44%,80.56%and 0.827,respectively.The accuracy,sensitivity,specificity,positive predictive value,negative predictive value and Kappa value of enhanced CT for diagnosing peripancreatic vein invasion were 86.84%,86.52%,88.00%,96.25%,64.71%and 0.660,respectively.Conclusion Enhanced CT has high value in preoperative evaluation of vascular invasion around pancreatic cancer,and preoperative evaluation is helpful for clinical diagnosis of tumor resectability.