Procacci C, Biasiutti C, Carbognin G, Accordini S, Bicego E, Guarise A, Spoto E, Andreis I A, De Marco R, Megibow A J
Department of Radiology, University of Verona Medical School, Policlinico G.B. Rossi, Italy.
J Comput Assist Tomogr. 1999 Nov-Dec;23(6):906-12. doi: 10.1097/00004728-199911000-00014.
The purpose of this work was to evaluate the capabilities of CT to accurately characterize cystic tumors of the pancreas.
Two observers retrospectively evaluated the CT exams of 100 cystic masses of the pancreas, with pathological confirmation. The two observers, blinded about clinical information and the final diagnosis, tried to categorize the lesions according to well established morphologic features. Statistical analysis was performed to measure the agreement between each radiologist and the consensus diagnosis and to evaluate the usefulness of certain CT findings in differentiating one type of cystic pancreatic neoplasm from another.
Serous cystadenoma was better diagnosed by CT [Youden misclassification index (Ymi) = 0.72] than mucinous cystic tumor (Ymi = 0.44) and solid pseudopapillary tumor (cystic variant) (Ymi = 0.47).
As patients with previous history of pancreatitis were excluded from the study, CT findings allowed correct characterization of only 60% of cystic pancreatic masses. Among the remaining 40%, 15-20% of the wrong diagnoses could not be corrected by means of CT, given the patterns shown by the tumors. In 20-25% of the cases, a nonspecific diagnosis of cystic mass was made.
本研究旨在评估CT准确鉴别胰腺囊性肿瘤的能力。
两名观察者对100例经病理证实的胰腺囊性肿块的CT检查进行回顾性评估。两名观察者对临床信息和最终诊断不知情，试图根据既定的形态学特征对病变进行分类。进行统计学分析以衡量每位放射科医生与共识诊断之间的一致性，并评估某些CT表现对鉴别不同类型胰腺囊性肿瘤的有用性。
CT对浆液性囊腺瘤的诊断效果（约登误分类指数[Ymi]=0.72）优于黏液性囊性肿瘤（Ymi=0.44）和实性假乳头状肿瘤（囊性变型）（Ymi=0.47）。
由于本研究排除了有胰腺炎既往史的患者，CT表现仅能正确鉴别60%的胰腺囊性肿块。在其余40%中，鉴于肿瘤表现的模式，15%-20%的错误诊断无法通过CT纠正。在20%-25%的病例中，做出了囊性肿块的非特异性诊断。
