Jang Dong Kee, Song Byeong Jun, Ryu Ji Kon, Chung Kwang Hyun, Lee Ban Seok, Park Joo Kyung, Lee Sang Hyub, Kim Yong-Tae, Lee Jae Young
From the *Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul; †Department of Internal Medicine, Seonam University Myongji Hospital, Goyang-si, Gyeonggi-do; and ‡Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
Pancreas. 2015 Nov;44(8):1329-33. doi: 10.1097/MPA.0000000000000396.
This study aimed to evaluate the accuracy of endoscopic ultrasound (EUS) and cross-sectional imaging including multidetector computed tomography (MDCT) or magnetic resonance imaging (MRI) as a preoperative diagnostic modality for the pancreatic cystic lesions.
Three hundred eighteen patients with surgically proven pancreatic cystic lesions were enrolled as a study cohort from 1998 to 2011. Preoperative radiological, EUS, and final histopathologic diagnosis were correlated to measure several kinds of diagnostic performance.
A total of 318 patients underwent preoperative MDCT, with additional imaging modalities such MRI and/or EUS in 215 (67.6%) and 108 (34.0%) patients, respectively. κ Values among the different modalities were as follows: MDCT versus pathology = 0.52 (P < 0.0001), MDCT + MRI versus pathology = 0.674 (P < 0.0001), and EUS versus pathology = 0.558 (P < 0.0001). The sensitivity and specificity in terms of ability to predict neoplastic cysts were as follows: MDCT, 83.1%/70.0%; MDCT + MRI, 94.7%/58.7%; and EUS, 88.5%/52.9%. The diagnostic accuracies of MDCT and MDCT + MRI were 61.4% (62/101) and 80.5% (173/215), respectively, and that of EUS was 70.4% (76/108).
Magnetic resonance imaging as an additional diagnostic modality to MDCT increased the accuracy, sensitivity, and specificity, as well in terms of predicting neoplastic cysts.
本研究旨在评估内镜超声（EUS）以及包括多排螺旋计算机断层扫描（MDCT）或磁共振成像（MRI）在内的断层成像作为胰腺囊性病变术前诊断方法的准确性。
选取1998年至2011年间318例经手术证实患有胰腺囊性病变的患者作为研究队列。将术前放射学检查、EUS检查结果与最终组织病理学诊断结果进行对比，以衡量几种诊断方法的性能。
共有318例患者接受了术前MDCT检查，另外分别有215例（67.6%）和108例（34.0%）患者接受了MRI和/或EUS等其他成像检查。不同检查方法之间的κ值如下：MDCT与病理学检查对比为0.52（P < 0.0001），MDCT + MRI与病理学检查对比为0.674（P < 0.0001），EUS与病理学检查对比为0.558（P < 0.0001）。预测肿瘤性囊肿的敏感性和特异性如下：MDCT为83.1%/70.0%；MDCT + MRI为94.7%/58.7%；EUS为88.5%/52.9%。MDCT和MDCT + MRI的诊断准确率分别为61.4%（62/101）和80.5%（173/215），EUS的诊断准确率为70.4%（76/108）。
磁共振成像作为MDCT的辅助诊断方法，在预测肿瘤性囊肿方面提高了准确性、敏感性和特异性。
