Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Eur Radiol. 2010 Jul;20(7):1757-67. doi: 10.1007/s00330-010-1727-5. Epub 2010 Feb 10.
To elucidate the multi-detector row computed tomography (MDCT) findings of extrapancreatic nerve plexus (PLX) invasion by pancreas head carcinoma (PhC) by "point-by-point" correlation with en bloc pathological specimens and to assess their diagnostic accuracy.
Each pathological section of PhC and adjusted double oblique multiplanar reconstruction MDCT images were correlated in 554 sections from 37 patients. The diagnostic accuracy of the MDCT patterns derived was assessed by blind reading.
PLX invasion with fibrosis showed mass or strand shape (85.6%) or coarse reticula (13.3%). The CT findings were divided into fine reticular and linear, coarse reticular, mass and strand, and nodular patterns. PLX invasion was revealed pathologically in 92% of the regions of investigation showing the mass and strand pattern and 63% of the coarse reticular pattern (all continuous with PhC), and they were highly suggestive of PLX invasion by PhC on MDCT images (p < 0.001). Sensitivity, specificity, accuracy, and positive and negative predictive values of these MDCT findings in the diagnosis of PLX invasion were 100% (25/25), 83.3% (10/12), 94.6% (35/37), 92.6% (25/27) and 100% (10/10), respectively.
The mass and strand pattern and the coarse reticular pattern continuous with PhC on MDCT images were highly suggestive of PLX invasion by PhC.
通过与整块病理标本的“逐点”相关联，阐明胰腺头部癌（PhC）对胰外神经丛（PLX）侵犯的多排螺旋 CT（MDCT）表现，并评估其诊断准确性。
对 37 例患者的 554 个病理节段进行 PhC 的每个病理节段和调整后的双斜多平面重建 MDCT 图像的相关性分析。通过盲法阅读评估 MDCT 模式的诊断准确性。
PLX 侵犯伴纤维化表现为肿块或条索状（85.6%）或粗网状（13.3%）。CT 表现分为细网状和线状、粗网状、肿块和条索状以及结节状。病理显示，肿块和条索状表现的 PLX 侵犯区域 92%，粗网状表现的 PLX 侵犯区域 63%（均与 PhC 连续），这强烈提示 PhC 侵犯 PLX 在 MDCT 图像上（p < 0.001）。这些 MDCT 表现对 PLX 侵犯的诊断的敏感性、特异性、准确性、阳性和阴性预测值分别为 100%（25/25）、83.3%（10/12）、94.6%（35/37）、92.6%（25/27）和 100%（10/10）。
MDCT 图像上与 PhC 连续的肿块和条索状及粗网状表现强烈提示 PhC 侵犯 PLX。
