Dipartimento di Scienze Biomorfologiche e Funzionali (DSBMF), Università degli Studi di Napoli Federico II (UNINA), Istituto di Biostrutture e Bioimmagini (IBB), Consiglio Nazionale delle Ricerche (CNR), Fondazione SDN (IRCCS), Napoli, Italy.
Radiol Med. 2010 Apr;115(3):453-66. doi: 10.1007/s11547-010-0490-7. Epub 2010 Jan 15.
This study compared the results of multislice computed tomography (MSCT) and high-field magnetic resonance imaging (MRI) in the diagnostic evaluation of pancreatic masses.
Forty patients with clinical and ultrasonographic evidence of pancreatic masses underwent MSCT and MRI. The majority of patients (31/40, 78%) had proven malignant pancreatic tumours (24 ductal adenocarcinoma, six mucinous cystadenocarcinoma, one intraductal papillary mucinous carcinoma), whereas the remaining patients (9/40, 22%) were found to have benign lesions (eight chronic pancreatitis, one serous cystadenoma). Results of the imaging studies were compared with biopsy (n=33) and/or histology (n=7) findings to calculate sensitivity, specificity, accuracy and positive (PPV) and negative (NPV) predictive value for correct identification of tumours and evaluation of resectability of malignancies.
Both for tumour identification and resectability, MSCT and MRI had comparable diagnostic accuracy, with no statistically significant differences between them. Tumour identification CT/MRI: accuracy 98/98%, sensitivity 100/100%, specificity 88/88%, PPV 97/97%, NPV 100/100%; tumour resectability CT/MRI: accuracy 94/90%, sensitivity 92/88%, specificity 100/100%, PPV 100/100%, NPV 78/70%.
MRI represents a valid diagnostic alternative to CT in the evaluation of patients with pancreatic masses, both for correct identification and characterisation of primary lesions and to establish resectability in the case of malignancies. New high-field MRI equipment allows optimal imaging quality with good contrast resolution in evaluating the upper abdomen.
本研究比较多层螺旋 CT（MSCT）和高场磁共振成像（MRI）在胰腺肿块诊断评估中的结果。
40 例临床和超声检查有胰腺肿块的患者接受了 MSCT 和 MRI 检查。大多数患者（31/40，78%）有经证实的恶性胰腺肿瘤（24 例导管腺癌、6 例黏液囊腺癌、1 例导管内乳头状黏液癌），而其余患者（9/40，22%）为良性病变（8 例慢性胰腺炎、1 例浆液性囊腺瘤）。将影像学研究结果与活检（n=33）和/或组织学（n=7）结果进行比较，以计算正确识别肿瘤和评估恶性肿瘤可切除性的敏感性、特异性、准确性以及阳性（PPV）和阴性（NPV）预测值。
无论是在肿瘤识别还是在可切除性评估方面，MSCT 和 MRI 的诊断准确性相当，两者之间无统计学差异。肿瘤识别 CT/MRI：准确性 98/98%、敏感性 100/100%、特异性 88/88%、PPV 97/97%、NPV 100/100%；肿瘤可切除性 CT/MRI：准确性 94/90%、敏感性 92/88%、特异性 100/100%、PPV 100/100%、NPV 78/70%。
MRI 是 CT 的一种有效替代方法，可用于评估胰腺肿块患者，不仅可正确识别和定性原发性病变，还可确定恶性肿瘤的可切除性。新型高场 MRI 设备可在评估上腹部时提供最佳的成像质量和良好的对比度分辨率。
