增强CT及DWI序列对胰腺炎与胰腺癌的诊断分析

摘要

Objective To investigate diagnostic value of enhanced CT andmagnetic resonance water diffusion weighted imaging (DWI) sequence for pancreatitis and pancreatic cancer.Methods From January 2014 to January 2016, 52 patients with pancreatic cancer were treated in our hospital, 58 cases of chronic pancreatitis were collected, and 20 normal volunteers were taken as control, the enhanced CT and DWI scan diagnosis and pathologic results were compared and analyzed.Results Enhanced CT diagnostic sensitivity was 88.46%, specificity was 84.48%, positive predictive value was 83.64%, negative predictive value was 89.09%;DWI scan diagnostic sensitivity was 84.62%, specificity was 82.76%, positive predictive value was 81.48%, negative predictive value was 85.71%;Pancreatic cancer pancreatic phaseCT value was (55.37±10.17) HU, which was significantly lower than the CT value in pancreatitis and normal pancreas (P<0.05).There was no significant difference in CT value between pancreatitis and normal pancreas (P>0.05);There was no significant difference in theplain CT values between the pancreatic cancer, pancreatitis and normal pancreas (P>0.05);Pancreatic cancer average apparent diffusion coefficient (ADC) was (1.420±0.102)×10-3 mm2/s, which was significantly higher than that of pancreatitis and normal pancreas (P<0.05);pancreatitis ADC was (1.076±0.101)×10-3 mm2/s, which was significantly lower than the normal pancreas (P<0.05).Conclusion CT enhanced scan and DWI MRI sequence in the differential diagnosis of pancreatitis and pancreatic cancer have a good clinical application value.%目的 探讨增强CT及磁共振水分子扩散加权成像(DWI)序列对胰腺炎与胰腺癌的诊断价值.方法 选取2014年1月~2016年1月院在我院治疗的胰腺癌患者52例,慢性胰腺炎患者58例,同时选取20例正常志愿者作为对照,将增强CT和DWI扫描诊断与病理结果进行比较分析.结果 增强CT诊断灵敏度88.46%,特异度84.48%,阳性预测值83.64%,阴性预测值89.09%;DWI扫描诊断灵敏度84.62%,特异度82.76%,阳性预测值81.48%,阴性预测值85.71%;胰腺癌胰腺期CT值为(55.37±10.17)HU,明显低于胰腺炎和正常胰腺胰腺期CT值(P<0.05);胰腺炎与正常胰腺胰腺期CT值差异无统计学意义(P>0.05);胰腺癌、胰腺炎和正常胰腺平扫CT值差异无统计学意义(P>0.05);胰腺癌平均表观弥散系数(ADC)为(1.420±0.102)×10-3mm2/s,明显高于胰腺炎和正常胰腺(P<0.05);胰腺炎ADC为(1.076±0.101)×10-3mm2/s,明显低于正常胰腺(P<0.05).结论 CT增强扫描与MRI DWI序列在胰腺炎与胰腺癌的鉴别诊断上,有较好的临床应用价值.