论文部分内容阅读
目的评价MRI判断胰腺癌胰周血管侵犯程度的价值,探讨MRI预测胰腺癌可切除性的最佳界点。方法搜集经手术病理证实的胰腺癌患者41例,均行MRI平扫及增强扫描,37例加做冠状位增强磁共振血管造影(MRA)。术前根据MRI表现,判断胰周血管侵犯情况,按照肿瘤对周围血管侵犯程度的不同,采用1级、2a级、2b级、3a级、3b级和4级进行评价,统计各分级血管的条数,并与手术结果对照。计算以2级和2a级作为可切除判断标准的敏感性、特异性、阳性预测值、阴性预测值和准确率应用受试者工作特性曲线(ROC)确定MRI预测胰腺癌可切除性的最佳界点。结果41例患者中,切除22例,其中20例为根治性切除,2例为姑息性切除。与手术结果对照,MRI共误诊7条血管,其中动脉3条,静脉4条。以1级、2a级、2b级、3a级和3b级作为可切除的标准,判断肿块不可切除的敏感性分别为78.3%、84.8%、67.4%、56.5%和47.8%。ROC曲线显示,以2a级作为MRI预测胰腺癌可切除的最佳界点。结论胰周血管侵犯2a级可作为MRI预测胰腺癌可切除的最佳界点。
Objective To evaluate the value of MRI in determining the extent of peripancreatic vascular invasion in pancreatic cancer and to explore the best cut point of MRI in predicting the resectability of pancreatic cancer. Methods Forty-one patients with pancreatic cancer confirmed by pathology were collected and scanned by MRI and enhanced MRI. Coronary MRA was performed in 37 patients. According to the MRI findings before operation, the perivascular vascular invasion was judged. According to the degree of invasion of the surrounding blood vessels by tumor, the grade 1, 2a, 2b, 3a, 3b and 4 were evaluated. Number, and with the surgical results. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the criteria for resectability at grade 2 and grade 2 were calculated using the receiver operating characteristic curve (ROC) to determine the best MRI for predicting the resectability of pancreatic cancer Boundary. Results Of the 41 patients, 22 were resected, of whom 20 were radical resection and 2 were palliative resection. Compared with the surgical results, MRI misdiagnosed seven blood vessels, of which 3 arteries, veins 4. The sensitivity of unresectable masses was 78.3%, 84.8%, 67.4%, 56.5% and 47.8%, respectively. The first, second, second, third and third graders were resectable criteria. The ROC curve shows that the optimal cut-off point of pancreatic adenocarcinoma using level 2a as MRI is shown. Conclusion Peripancreatic vascular invasion level 2a can be used as the best cutpoint for the prediction of pancreatic cancer.