一种区分局灶型自身免疫性胰腺炎与胰腺导管腺癌的可行 CT 特征。
A feasible CT feature to differentiate focal-type autoimmune pancreatitis from pancreatic ductal adenocarcinoma.
机构信息
State Key Laboratory of Oncology in South China, Department of Pancreatobiliary Surgery, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University (SYSU), Guangzhou, Guangdong, China.
出版信息
Cancer Med. 2019 Oct;8(14):6250-6257. doi: 10.1002/cam4.2526. Epub 2019 Aug 30.
BACKGROUND
To investigate whether the relative computed tomography (CT) value (rCT) of adjacent pancreatic parenchyma can distinguish focal-type autoimmune pancreatitis (fAIP) from pancreatic ductal adenocarcinoma (PDAC).
METHODS
A total of 13 patients with fAIP and 20 patients with PDAC were included in this study. The rCT was calculated as the ratio of the CT value of adjacent pancreatic parenchyma to that of muscle. The diagnostic performance of rCT for discriminating fAIP from PDAC was evaluated using receiver operating characteristic (ROC) analysis.
RESULTS
Both fAIP and PDAC presented hyper-fibrosis histologically and delayed enhancement on CT examination. Moreover, the pancreatic parenchyma of fAIP presented serious inflammation. The mean rCT of the parenchyma was significantly lower in fAIP than in PDAC in all phases. The best diagnostic performance of the rCT value was found in the pancreatic phase, with an area under the ROC curve of 0.912, while the areas under the ROC curve of the portal and delayed phases were 0.812 and 0.754, respectively. The optimal cut-off value for distinguishing fAIP from PDAC was 1.62 in the pancreatic phase.
CONCLUSIONS
The rCT of the pancreatic parenchyma during the pancreatic phase may be a feasible CT feature for differentiating fAIP from PDAC.
背景
为了探究毗邻胰腺实质的相对 CT 值（rCT）是否可以区分局灶型自身免疫性胰腺炎（fAIP）和胰腺导管腺癌（PDAC）。
方法
本研究共纳入 13 例 fAIP 患者和 20 例 PDAC 患者。rCT 计算为毗邻胰腺实质的 CT 值与肌肉 CT 值的比值。采用受试者工作特征（ROC）曲线分析评估 rCT 对 fAIP 与 PDAC 进行鉴别诊断的性能。
结果
fAIP 和 PDAC 在组织学上均表现为纤维组织增生，CT 检查时呈延迟强化。此外，fAIP 的胰腺实质表现出严重的炎症。在所有期相，fAIP 的胰腺实质 rCT 值均显著低于 PDAC。rCT 值在胰腺期的诊断性能最佳，ROC 曲线下面积为 0.912，门静脉期和延迟期的 ROC 曲线下面积分别为 0.812 和 0.754。胰腺期区分 fAIP 和 PDAC 的最佳 rCT 值截断值为 1.62。
结论
胰腺期胰腺实质的 rCT 值可能是区分 fAIP 和 PDAC 的一种可行的 CT 特征。
Zotero 插件