Bipat Shandra, Phoa Saffire S K S, van Delden Otto M, Bossuyt Patrick M M, Gouma Dirk J, Laméris Johan S, Stoker Jaap
Department of Radiology, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands.
J Comput Assist Tomogr. 2005 Jul-Aug;29(4):438-45. doi: 10.1097/01.rct.0000164513.23407.b3.
To compare ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) in the diagnosis and determination of resectability of pancreatic adenocarcinoma.
Articles reporting US, CT, or MRI data of patients with known or suspected pancreatic adenocarcinoma and at least 20 patients verified with histopathology, surgical findings, or follow-up were included. A bivariate random effects approach was used to calculate sensitivity and specificity for diagnosis and resectability of pancreatic adenocarcinoma.
Sixty-eight articles fulfilled all inclusion criteria. For diagnosis, sensitivities of helical CT, conventional CT, MRI, and US were 91%, 86%, 84%, and 76% and specificities were 85%, 79%, 82%, and 75% respectively. Sensitivities for MRI and US were significantly lower compared with helical CT (P = 0.04 and P = 0.0001). For determining resectability, sensitivities of helical CT, conventional CT, MRI, and US were 81%, 82%, 82, and 83% and specificities were 82%, 76%, 78%, and 63% respectively. Specificity of US was significantly lower compared with helical CT (P = 0.011).
Helical CT is preferable as an imaging modality for the diagnosis and determination of resectability of pancreatic adenocarcinoma.
比较超声检查（US）、计算机断层扫描（CT）和磁共振成像（MRI）在胰腺腺癌诊断及可切除性判定中的应用。
纳入报告已知或疑似胰腺腺癌患者的US、CT或MRI数据，且至少有20例经组织病理学、手术结果或随访证实的患者的文章。采用双变量随机效应方法计算胰腺腺癌诊断及可切除性的敏感性和特异性。
68篇文章符合所有纳入标准。对于诊断，螺旋CT、传统CT、MRI和US的敏感性分别为91%、86%、84%和76%，特异性分别为85%、79%、82%和75%。与螺旋CT相比，MRI和US的敏感性显著较低（P = 0.04和P = 0.0001）。对于判定可切除性，螺旋CT、传统CT、MRI和US的敏感性分别为81%、82%、82%和83%，特异性分别为82%、76%、78%和63%。与螺旋CT相比，US的特异性显著较低（P = 0.011）。
螺旋CT作为胰腺腺癌诊断及可切除性判定的成像方式更为可取。
