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胰腺实质部分萎缩是诊断包括原位癌在内的小胰腺癌（≤10mm）的一项新的特异性发现：与局限性良性主胰管狭窄患者的比较。

Partial Pancreatic Parenchymal Atrophy Is a New Specific Finding to Diagnose Small Pancreatic Cancer (≤10 mm) Including Carcinoma in Situ: Comparison with Localized Benign Main Pancreatic Duct Stenosis Patients.

作者信息

Yamao Kentaro, Takenaka Mamoru, Ishikawa Rei, Okamoto Ayana, Yamazaki Tomohiro, Nakai Atsushi, Omoto Shunsuke, Kamata Ken, Minaga Kosuke, Matsumoto Ippei, Takeyama Yoshifumi, Numoto Isao, Tsurusaki Masakatsu, Chikugo Takaaki, Chiba Yasutaka, Watanabe Tomohiro, Kudo Masatoshi

机构信息

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka 589-8511, Japan.

Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka 589-8511, Japan.

出版信息

Diagnostics (Basel). 2020 Jul 1;10(7):445. doi: 10.3390/diagnostics10070445.

DOI:10.3390/diagnostics10070445
PMID:32630180
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7400308/
Abstract

BACKGROUND

This study aimed to evaluate and identify the specific CT findings by focusing on abnormalities in the main pancreatic duct (MPD) and pancreatic parenchyma in patients with small pancreatic cancer (PC) including carcinoma in situ (CIS).

METHODS

Nine CT findings indicating abnormalities of MPD and pancreatic parenchyma were selected as candidate findings for the presence of small PC ≤ 10 mm. The proportions of patients positive for each finding were compared between small PC and benign MPD stenosis groups. Interobserver agreement between two independent image reviewers was evaluated using kappa statistics.

RESULTS

The final analysis included 24 patients with small PC (including 11 CIS patients) and 28 patients with benign MPD stenosis. The proportion of patients exhibiting partial pancreatic parenchymal atrophy (PPA) corresponding to the distribution of MPD stenosis (45.8% vs. 7.1%, < 0.01), upstream PPA arising from the site of MPD stenosis (33.3% vs. 3.6%, = 0.01), and MPD abrupt stenosis (45.8% vs. 14.3%, = 0.03) was significantly higher in the small PC group than in the benign MPD stenosis group.

CONCLUSIONS

The presence of partial PPA, upstream PPA, and MPD abrupt stenosis on a CT image was highly suggestive of the presence of small PCs including CIS.

摘要

背景

本研究旨在通过聚焦于小胰腺癌（PC）患者（包括原位癌（CIS））的主胰管（MPD）和胰腺实质异常，评估并识别特定的CT表现。

方法

选择9项提示MPD和胰腺实质异常的CT表现作为直径≤10mm的小PC存在的候选表现。比较小PC组和良性MPD狭窄组中每项表现阳性患者的比例。使用kappa统计量评估两名独立影像阅片者之间的观察者间一致性。

结果

最终分析纳入24例小PC患者（包括11例CIS患者）和28例良性MPD狭窄患者。小PC组中出现与MPD狭窄分布相对应的部分胰腺实质萎缩（PPA）（45.8%对7.1%，<0.01）、源于MPD狭窄部位的上游PPA（33.3%对3.6%，=0.01）以及MPD突然狭窄（45.8%对14.3%，=0.03）的患者比例显著高于良性MPD狭窄组。

结论

CT图像上出现部分PPA、上游PPA和MPD突然狭窄高度提示存在包括CIS在内的小PC。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/f48bd84777c9/diagnostics-10-00445-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/1c779fa3f1fa/diagnostics-10-00445-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/43fe2582408c/diagnostics-10-00445-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/2ad1214bd161/diagnostics-10-00445-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/f344665f6c07/diagnostics-10-00445-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/2cbf1705ed86/diagnostics-10-00445-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/105390894760/diagnostics-10-00445-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/655cddaa15c3/diagnostics-10-00445-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/f48bd84777c9/diagnostics-10-00445-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/1c779fa3f1fa/diagnostics-10-00445-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/43fe2582408c/diagnostics-10-00445-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/2ad1214bd161/diagnostics-10-00445-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/f344665f6c07/diagnostics-10-00445-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/2cbf1705ed86/diagnostics-10-00445-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/105390894760/diagnostics-10-00445-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/655cddaa15c3/diagnostics-10-00445-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dce/7400308/f48bd84777c9/diagnostics-10-00445-g008.jpg

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