Pancreatic adenocarcinoma versus chronic pancreatitis: differentiation with triple-phase helical CT
Pancreatic adenocarcinoma versus chronic pancreatitis: differentiation with triple-phase helical CT
复制标题
DOI：
10.1007/s00261-009-9579-7
复制
发表时间：
2010-04-01
影响因子：
--
通讯作者：
Hongo, Norio
中科院分区：
文献类型：
--
作者：
Yamada, Yasunari;Mori, Hiromu;Hongo, Norio
慢性胰腺炎和胰腺癌的临床和影像学表现往往相似。本研究的目的是通过定义在两种病理状态下的增强模式来区分慢性胰腺炎和胰腺癌。根据方案A获得的CT图像（扫描延迟，30、60和150 s; 300 mg I/mL造影剂）或方案B（扫描延迟，40、70和150 s;正常胰腺的平均增强值在第1时相达到峰值慢性胰腺炎在第二阶段达到高峰（延迟洗脱模式），胰腺癌在两种方案中均逐渐上升（增加模式）。A、B方案诊断胰腺癌的敏感性分别为82.4%和94.1%，特异性分别为83%和83%，准确性分别为82.7%和90.4%，我们的研究结果表明，从三重组织中获得的时间衰减曲线，螺旋CT B期扫描对慢性胰腺炎和胰腺癌的鉴别诊断有重要价值。
Chronic pancreatitis and pancreatic adenocarcinoma often show similar clinical and imaging appearances. This study aims to differentiate chronic pancreatitis from pancreatic adenocarcinoma by defining enhancement patterns in both pathologic conditions during triple-phase helical CT.The study included 42 patients with chronic pancreatitis and 85 patients with pancreatic adenocarcinoma. CT images obtained according to protocol A (scan delays, 30, 60, and 150 s; 300 mg I/mL contrast material) or protocol B (scan delays, 40, 70, and 150 s; 370 mg I/mL contrast material) were retrospectively evaluated.Mean contrast enhancement value of normal pancreas peaked in the first phase (early-washout pattern) while that of chronic pancreatitis peaked in the second phase (delayed-washout pattern), and that of pancreatic adenocarcinoma gradually rose (increasing pattern) in both protocols. Diagnostic indices for pancreatic adenocarcinoma were 82.4% and 94.1% for sensitivity, 83% and 83% for specificity, 82.7% and 90.4% for accuracy in protocols A and B, respectively, when differentiation between chronic pancreatitis and pancreatic adenocarcinoma was performed based on time-attenuation curve patterns.Our results indicate that time attenuation curves obtained from triple-phase helical CT in protocol B provide useful information in differentiating chronic pancreatitis from pancreatic adenocarcinoma.