腹部CT和EUS检查慢性胰腺炎患者表现特点及其诊断价值分析*

目的 探讨腹部CT和超声内镜（EUS）检查对不同临床分期的慢性胰腺炎（CP）患者的诊断价值。方法 2012年5月~2017年3月我院收治的78例CP患者,均行EUS、腹部CT和胰腺组织病理学检查。应用受试者工作特征（ROC）曲线分析腹部CT和EUS检查对CP临床分期的诊断价值。结果 经组织病理学检查,本组诊断1期CP患者28例,2期24例,3期26例;EUS对1期CP诊断的AUC为0.85（95%CI：0.75~0.92）,其敏感度为85.7%,特异性为84.0%,准确性为84.6%,而腹部CT诊断1期CP的AUC为0.72（95%CI：0.61~0.82）,其敏感度为60.7%,特异性为88.0%,准确性为78.2%;EUS诊断2期CP的AUC为0.81（95%CI：0.70~0.89）,其敏感度为79.2%,特异性为81.5%,准确度为80.8%,而CT诊断2期CP的AUC为0.73（95%CI：0.62~0.82）,其敏感度为62.5%,特异性为85.2%,准确度为78.2%;EUS诊断3期CP的AUC为0.75（95%CI：0.64~0.84）,其敏感度为84.6%,特异性为85.2%,准确度为85.0%,而CT诊断3期CP的AUC为0.69（95%CI：0.57~0.79）,其敏感度为69.2%,特异性为88.9%,准确度为82.5%。结论 EUS和腹部CT检查诊断CP患者具有较高的价值,但在1期CP患者,EUS的诊断效能可能优于腹部CT检查。

Comparison of diagnostic efficacy of abdominal CT and EUS examination in patients with chronic pancreatitis

Objective To investigate the diagnostic efficacy of abdominal CT and endoscopic ultrasonography （EUS） examination in patients with chronic pancreatitis （CP）. Methods 78 patients with CP were recruited in this study between May 2012 and March 2017,and all of them were examined by EUS and abdominal CT. The diagnostic efficacy was analyzed by ROC curve. Results The histopathological examination showed that there were 28 patients with CP stage 1, 24 with CP stage 2,and 26 with CP stage 3; the AUC by EUS in diagnosing patients with CP stage 1 was 0.85（95%CI：0.75-0.92）,with the sensitivity （Se） of 85.7%,specificity （Sp） of 84.0%,and accuracy （Ac） of 84.6%,while the AUC by CT examination was 0.72（95%CI：0.61-0.82）,with the Se of 60.7%,Sp of 88.0%,and Ac of 78.2%; the AUC by EUS in diagnosing patients with CP stage 2 was 0.81（95%CI：0.70-0.89）,with Se of 79.2%,Sp of 81.5%,and Ac of 80.8%,while the AUC by CT was 0.73（95%CI：0.62~0.82）,with Se of 62.5%,Sp of 85.2%,and Ac of 78.2%; the AUC by EUS in diagnosing CP stage 3 was 0.75（95%CI：0.64-0.84）,with Se of 84.6%,Sp of 85.2%,and Ac of 85.0%,while the AUC by CT was 0.69（95%CI：0.57-0.79）,with Se of 69.2%,Sp of 88.9%,and Ac of 82.5%. ConclusionThe application of EUS and CT in the diagnosis of patients with CP is both highly efficient,and we recommend the EUS examination especially in patients with early CP in clinical practice.