Campisi A, Brancatelli G, Vullierme M-P, Levy P, Ruszniewski P, Vilgrain V
Department of Radiology, University of Palermo, Palermo, Italy.
Clin Radiol. 2009 Sep;64(9):903-11. doi: 10.1016/j.crad.2009.05.005.
To retrospectively establish the most frequently encountered diagnoses in patients with pancreatic calcifications and to investigate whether the association of certain findings could be helpful for diagnosis.
One hundred and three patients were included in the study. The location and distribution of calcifications; presence, nature, and enhancement pattern of pancreatic lesions; pancreatic atrophy and ductal dilatation were recorded. Differences between patients with chronic pancreatitis and patients with other entities were compared by using Fisher's exact test.
Patients had chronic pancreatitis (n=70), neuroendocrine tumours (n=14), intraductal papillary mucinous neoplasm (n=11), pancreatic adenocarcinoma (n=4), serous cystadenoma (n=4). Four CT findings had a specificity of over 60% for the diagnosis of chronic pancreatitis: parenchymal calcifications, intraductal calcifications, parenchymal atrophy, and cystic lesions. When at least two of these four criteria were used in combination, 54 of 70 (77%) patients with chronic pancreatitis could be identified, but only 17 of 33 (51%) patients with other diseases. When at least three of these four criteria were present, a specificity of 79% for the diagnosis of chronic pancreatitis was achieved.
Certain findings are noted more often in chronic pancreatitis than in other pancreatic diseases. The presence of a combination of CT findings can suggest chronic pancreatitis and be helpful in diagnosis.
回顾性确定胰腺钙化患者中最常见的诊断，并研究某些影像学表现之间的关联是否有助于诊断。
本研究纳入了103例患者。记录钙化的位置和分布；胰腺病变的存在、性质及强化方式；胰腺萎缩和导管扩张情况。采用Fisher精确检验比较慢性胰腺炎患者与其他疾病患者之间的差异。
患者患有慢性胰腺炎（n = 70）、神经内分泌肿瘤（n = 14）、导管内乳头状黏液性肿瘤（n = 11）、胰腺腺癌（n = 4）、浆液性囊腺瘤（n = 4）。四项CT表现对慢性胰腺炎诊断的特异性超过60%：实质钙化、导管内钙化、实质萎缩和囊性病变。当联合使用这四项标准中的至少两项时，70例慢性胰腺炎患者中有54例（77%）可被识别，但33例其他疾病患者中只有17例（51%）。当存在这四项标准中的至少三项时，慢性胰腺炎诊断的特异性达到79%。
某些影像学表现在慢性胰腺炎中比在其他胰腺疾病中更常见。CT表现的联合出现可提示慢性胰腺炎，有助于诊断。
