小成像视野薄层靶扫描胰腺动脉计算机断层扫描增强检查在胰腺癌诊断中的应用

目的 探讨小成像视野薄层靶扫描胰腺动脉计算机断层扫描（CT）增强检查在胰腺癌诊断中的应用价值。方法 收集36例经术后病理证实的胰腺癌患者的临床资料。所有患者术前均行小成像视野薄层靶扫描胰腺动脉CT增强检查。以病理结果为"金标准",计算小成像视野薄层靶扫描胰腺动脉CT增强检查评估肿瘤大小、血管侵犯、动脉起源变异和淋巴结转移的准确度、灵敏度、特异度、阳性预测值与阴性预测值。使用Kappa检验评价小成像视野薄层靶扫描胰腺动脉CT增强检查对胰腺癌的诊断价值。结果 小成像视野薄层靶扫描胰腺动脉CT增强检查对肿瘤大小的诊断准确度、灵敏度、特异度、阳性预测值、阴性预测值均为1.00;对血管侵犯以及动脉起源变异的诊断准确度、灵敏度均为1.00,特异度达0.97以上;对淋巴结转移的诊断准确度、灵敏度、特异度、阳性预测值、阴性预测值分别为0.89、0.75、1.00、1.00、0.83。小成像视野薄层靶扫描胰腺动脉CT增强检查结果与病理结果一致性极好（Kappa值均>0.75）。结论 小成像视野薄层靶扫描胰腺动脉CT增强检查能够全面评价胰腺癌病灶、病灶边缘、病灶与周围血管关系及周围淋巴结转移,提高了胰腺癌手术可切除性评价的准确性。

Diagnostic value of small field of view thin slice target scanning of pancreatic artery computed tomography enhanced angiography for pancreatic cancer

Objective To analyze the diagnostic value of computed tomography (CT) enhanced angiography of pancreatic artery with thin slice target scanning of field of view (FOV) for pancreatic cancer. Methods Clinical data of 36 patients with pancreatic cancer confirmed by postoperative pathology were collected. All patients received CT enhanced angiography of pancreatic artery with thin slice target scanning of FOV before operation, and the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the CT enhanced angiography of pancreatic artery with thin slice target scanning of FOV in evaluating tumor size, vascular invasion, arterial origin variation, and node metastasis were calculated with pathological results being the "gold standard". The Kappa test was used to evaluate the diagnostic value of CT enhanced angiography of pancreatic artery with thin slice target scanning of FOV for pancreatic cancer. Results The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CT enhanced angiography of pancreatic artery with thin slice target scanning of FOV for tumor size were all 1.00; the diagnostic accuracy and sensitivity for vascular invasion and arterial origin variation were all 1.00, and the specificity was 0.97 or more; the diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for lymph node metastasis were 0.89, 0.75, 1.00, 1.00, and 0.83, respectively. The consistency of pathology and CT enhanced angiography of pancreatic artery with thin slice target scanning of FOV was good in evaluating pancreatic cancer (all Kappa>0.75). Conclusion CT enhanced angiography of pancreatic artery with thin slice target scanning of FOV is a comprehensive method in evaluating pancreatic tumors, tumor margin, relationship between tumor and peripheral vessels, and peripheral lymph node metastasis, and it can improve the accuracy of surgical resectability evaluation of pancreatic cancer.