MSCT和MRI增强扫描诊断胰腺癌与慢性胰腺炎临床分析
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摘要
目的分析MSCT和MRI增强扫描在胰腺癌与慢性胰腺炎诊断中的应用。方法将62例患者作为研究对象。所有患者在手术治疗与随访前均接受MSCT、MRI增强扫描,对比胰腺癌与慢性胰腺炎影像学特征、病理性质的差异并纳入统计学分析。结果通过MSCT和MRI增强扫描结果得知:胰腺癌患者胰腺体积增大、胰腺周围组织及大血管的侵犯、胰腺周围淋巴结肿大、动脉期强化不明显、胰胆管不规则扩张等情况的发生率显著高于慢性胰腺炎患者(P <0. 05);慢性胰腺炎患者病变及病变周围囊肿、病变钙化、胰胆管平滑状扩张等情况的发生率显著高于胰腺癌患者(P <0. 05);采用MSCT和MRI增强扫描联合应用,在临床中的诊断率显著高于单一使用MSCT或单一使用MRI的诊断准确率(P <0. 05); MSCT与MRI单项诊断结果无差异性(P> 0. 05)。结论 MSCT与MRI增强扫描联合应用在胰腺癌与慢性胰腺炎的临床诊断中具有较高的诊断准确率。
Objective To analyze the application of MSCT and MRI enhanced scan in the diagnosis of pancreatic cancer andchronic pancreatitis. Methods 62 patients with pancreatic cancer and chronic pancreatitis admitted to our hospital from March2014 to March 2017 were enrolled in this study. All patients underwent MSCT and MRI enhanced scans before surgical treatment.The above images were analyzed by imaging specialists to compare the imaging characteristics and pathological features of pancre-atic cancer and chronic pancreatitis. The results of this study data were included in statistical software analysis. Results MSCTand MRI enhanced scan results showed that pancreatic cancer patients with pancreas increased volume,pancreatic tissue and thesurrounding large blood vessels,lymph nodes around the pancreas,arterial enhancement was not obvious,the incidence of irregu-lar expansion of pancreaticobiliary duct were significantly higher than in patients with chronic pancreatitis( P < 0. 05). The inci-dence of cystic lesions,calcified lesions and smooth pancreatic duct dilatation in patients with chronic pancreatitis were signifi-cantly higher than those in patients with pancreatic cancer( P < 0. 05). The diagnostic accuracy of MSCT combined with MRIenhanced scan in clinical diagnosis was significant higher than those single-use MSCT or single-use MRI( P < 0. 05). There wasno significant difference between single diagnosis of MSCT and MRI( P > 0. 05). Conclusion Compared with the single use ofany one diagnosis,MSCT combined with MRI enhanced scan in the clinical diagnosis of pancreatic cancer and chronic pancreatitishave a higher diagnostic accuracy and can distinguish the pathological nature of the disease,which provides a scientific and favor-able data support for the follow-up clinical treatment,with clinical application value.
Objective To analyze the application of MSCT and MRI enhanced scan in the diagnosis of pancreatic cancer andchronic pancreatitis. Methods 62 patients with pancreatic cancer and chronic pancreatitis admitted to our hospital from March2014 to March 2017 were enrolled in this study. All patients underwent MSCT and MRI enhanced scans before surgical treatment.The above images were analyzed by imaging specialists to compare the imaging characteristics and pathological features of pancre-atic cancer and chronic pancreatitis. The results of this study data were included in statistical software analysis. Results MSCTand MRI enhanced scan results showed that pancreatic cancer patients with pancreas increased volume,pancreatic tissue and thesurrounding large blood vessels,lymph nodes around the pancreas,arterial enhancement was not obvious,the incidence of irregu-lar expansion of pancreaticobiliary duct were significantly higher than in patients with chronic pancreatitis( P < 0. 05). The inci-dence of cystic lesions,calcified lesions and smooth pancreatic duct dilatation in patients with chronic pancreatitis were signifi-cantly higher than those in patients with pancreatic cancer( P < 0. 05). The diagnostic accuracy of MSCT combined with MRIenhanced scan in clinical diagnosis was significant higher than those single-use MSCT or single-use MRI( P < 0. 05). There wasno significant difference between single diagnosis of MSCT and MRI( P > 0. 05). Conclusion Compared with the single use ofany one diagnosis,MSCT combined with MRI enhanced scan in the clinical diagnosis of pancreatic cancer and chronic pancreatitishave a higher diagnostic accuracy and can distinguish the pathological nature of the disease,which provides a scientific and favor-able data support for the follow-up clinical treatment,with clinical application value.
引文
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[11]田笑,周欢,魏惠敏.MRCP对胰头癌与胰头部肿块型慢性胰腺炎的鉴别诊断价值[J].山东医药,2010,50(52):62-64.
[12]金韬,王超.联合应用CT、MRI增强扫描鉴别诊断胰腺癌与慢性胰腺炎[J].健康研究,2017,37(2):192-194.
[13]王金成.MRI对慢性胰腺炎与胰腺癌的临床诊断分析[J].临床医药文献电子杂志,2017,4(37):7263-7264.
[14]刘长志.多种MRI技术联合应用鉴别诊断胰腺癌与慢性胰腺炎[J].中外女性健康研究,2017,2017(4):24-26.
[15]罗娅红,于韬,王洋,等.联合应用CT、MRI增强扫描鉴别诊断胰腺癌与慢性胰腺炎[J].磁共振成像,2011,2(1):42-46.
[2]Wilson RH,Chandra M,Scheiman JM,et al.Tissue classification using optical spectroscopy accurately differentiates cancer and chronic pancreatitis[J].Pancreas,2017,46(2):244-251.
[3]杨尹默,刘子文,赵玉沛,等.胰腺癌诊治指南(2014)[J].中国实用外科杂志,2014,34(11):1011-1017.
[4]苗毅,刘续宝,赵玉沛,等.慢性胰腺炎诊治指南(2014)[J].中国实用外科杂志,2015,35(3):277-282.
[5]闫爽.超声联合多层螺旋CT诊断胰腺癌的临床价值[J].中国CT和MRI杂志,2017,15(4):100-102.
[6]王文治.多层螺旋CT灌注成像在胰腺癌诊断中的临床价值[J].临床医学研究与实践,2017,2(2):100-101.
[7]Kirkegrd J,Mortensen FV,Croninfenton D.Chronic pancreatitis and pancreatic cancer risk:a systematic review and meta-analysis[J].American Journal of Gastroenterology,2017,112(9):1366-1372.
[8]张明,徐晓,杨福东,等.探讨联合应用CT、MRI增强扫描鉴别诊断胰腺癌与慢性胰腺炎[J].中国医药指南,2015,(23):49-50.
[9]覃品.CT联合MRI增强扫描鉴别诊断胰腺癌与慢性胰腺炎[J].按摩与康复医学,2016,7(2):120-121.
[10]李亮,程三房,乔万海.胰腺癌的多层螺旋CT及MRI影像学诊断分析[J].中国CT和MRI杂志,2016,14(8):4-6.
[11]田笑,周欢,魏惠敏.MRCP对胰头癌与胰头部肿块型慢性胰腺炎的鉴别诊断价值[J].山东医药,2010,50(52):62-64.
[12]金韬,王超.联合应用CT、MRI增强扫描鉴别诊断胰腺癌与慢性胰腺炎[J].健康研究,2017,37(2):192-194.
[13]王金成.MRI对慢性胰腺炎与胰腺癌的临床诊断分析[J].临床医药文献电子杂志,2017,4(37):7263-7264.
[14]刘长志.多种MRI技术联合应用鉴别诊断胰腺癌与慢性胰腺炎[J].中外女性健康研究,2017,2017(4):24-26.
[15]罗娅红,于韬,王洋,等.联合应用CT、MRI增强扫描鉴别诊断胰腺癌与慢性胰腺炎[J].磁共振成像,2011,2(1):42-46.