Nakagawa Akihiko, Yamaguchi Taketo, Ohtsuka Masayuki, Ishihara Takeshi, Sudo Kentaro, Nakamura Kazuyoshi, Hara Taro, Denda Tadamichi, Miyazaki Masaru
Department of Gastroenterology, Numazu Municipal Hospital, Shizuoka, Japan.
Pancreas. 2009 Mar;38(2):131-6. doi: 10.1097/MPA.0b013e31818b0040.
To retrospectively evaluate the usefulness of multidetector computed tomography (MDCT) with multiplanar reformations (MPRs) and curved planar reformations (CPRs) for detecting protruding lesions in intraductal papillary mucinous neoplasms of the pancreas (IPMNs) as compared with single-detector CT (SDCT) and endoscopic ultrasonography (EUS).
Eighty-six patients with IPMNs were imaged either with SDCT (n = 52) or MDCT with MPRs/CPRs and EUS (n = 34). The diagnostic accuracy of each imaging modality for identifying protruding lesions was compared with histological samples.
Among the patients in whom protruding lesions were histopathologically identified, the lesions were detected in 9 of the 33 patients subjected to SDCT (51.9% accuracy), in 17 of the 25 patients subjected to MDCT with MPRs and CPRs (76.5% accuracy), and in 21 of the 25 patients subjected to EUS (70.6% accuracy). Thus, significant difference was observed between MDCT and SDCT regarding accuracy (P < 0.05); however, no significant difference was seen between MDCT and EUS. Protruding lesions of less than 10 mm in height were better visualized with MDCT (53.3%) than with SDCT (13.0%; P < 0.05).
Multidetector computed tomography proved more useful than SDCT and equivalent to EUS in detecting protruding lesions in IPMNs.
回顾性评估多排螺旋计算机断层扫描(MDCT)结合多平面重组(MPR)和曲面重组(CPR)技术检测胰腺导管内乳头状黏液性肿瘤(IPMNs)突出性病变的有效性,并与单排螺旋CT(SDCT)及内镜超声(EUS)进行比较。
86例IPMNs患者分别接受了SDCT检查(n = 52)或MDCT结合MPR/CPR及EUS检查(n = 34)。将每种成像方式识别突出性病变的诊断准确性与组织学样本进行比较。
在经组织病理学确诊有突出性病变的患者中,接受SDCT检查的33例患者中有9例检测到病变(准确率51.9%),接受MDCT结合MPR和CPR检查的25例患者中有17例检测到病变(准确率76.5%),接受EUS检查的25例患者中有21例检测到病变(准确率70.6%)。因此,MDCT与SDCT在准确性方面存在显著差异(P < 0.05);然而,MDCT与EUS之间未观察到显著差异。高度小于10 mm的突出性病变,MDCT的可视化效果(53.3%)优于SDCT(13.0%;P < 0.05)。
在检测IPMNs的突出性病变方面,多排螺旋计算机断层扫描比SDCT更有用,且与EUS等效。