CEUS定量分析鉴别诊断胰腺癌和肿块型胰腺炎

目的探讨CEUS时间-强度曲线(TIC)鉴别诊断胰腺癌和肿块型胰腺炎的价值。方法对经病理或临床确诊的29例胰腺癌患者和17例肿块型胰腺炎患者行CEUS检查,应用TIC分析计算病灶内造影剂到达时间(AT)、达峰时间(TTP)、峰值强度(Imax)、渡越时间(TT)。结果胰腺癌的AT大于肿块型胰腺炎[(11.06±3.54)s vs(8.41±3.11)s,P<0.05)],胰腺癌的Imax明显小于肿块型胰腺炎(44.30%vs 86.57%,P<0.05)。以AT≥9.45s诊断胰腺癌,敏感度、特异度、阳性预测值、阴性预测值、准确率分别为75.86%、70.59%、81.48%、63.16%、73.91%;以Imax≤72.14%诊断胰腺癌,敏感度、特异度、阳性预测值、阴性预测值、准确率分别为72.41%、64.71%、77.78%、57.89%、69.57%;以AT≥9.45s或Imax≤72.14%为标准诊断胰腺癌,敏感度、阴性预测值和准确率增大(93.10%、81.82%和78.26%)。结论 CEUS定量分析可为鉴别诊断胰腺癌和肿块型胰腺炎提供更客观、有力的依据。

Quantitative analysis with CEUS in differential diagnosis of pancreatic carcinoma and mass forming pancreatitis

Objective To explore the value of time-intensity curve(TIC) with CEUS in differential diagnosis of pancreatic carcinoma and mass forming pancreatitis.Methods Twenty-nine patients with pancreatic carcinoma and 17patients with mass forming pancreatitis underwent CEUS.The arrival time(AT),time to peak(TTP),maximum intensity(I max) and transit time(TT) of all the lesions were calculated with TIC.Results AT of pancreatic carcinoma was longer than that of mass forming pancreatitis([ 11.06±3.54 ] s vs [ 8.41±3.11 ] s,P<0.05).I max of pancreatic carcinoma was lower than that of mass forming pancreatitis(44.30%vs 86.57%,P<0.05).Using AT≥9.45sas diagnostic indicator for differentiating pancreatic carcinoma from mass forming pancreatitis,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy rate was 75.86%,70.59%,81.48%,63.16% and 73.91%,respectively,while using Imax≤ 72.14%as diagnostic indicator,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy rate was 72.41%,64.71%,77.78%,57.89%and 69.57%,respectively.Taking AT≥9.45sor Imax≤72.14%as diagnostic indicator,the sensitivity,negative predictive value and accuracy rate increased(93.10%,81.82% and 78.26%).Conclusion Quantitative analysis with CEUS could provide objective and effective criterion for differential diagnosis of pancreatic carcinoma and mass forming pancreatitis.