Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Gyeonggi-do 18450, South Korea.
Department of Radiology, Hallym University Sacred Heart Hospital, Gyeonggi-do 14068, South Korea.
World J Gastroenterol. 2020 Jul 28;26(28):4151-4158. doi: 10.3748/wjg.v26.i28.4151.
Pancreatic ductal adenocarcinoma (PDA) is a malignancy with a high mortality rate and short survival time. The conventional computed tomography (CT) has been worldwide used as a modality for diagnosis of PDA, as CT enhancement pattern has been thought to be related to tumor angiogenesis and pathologic grade of PDA.
To evaluate the relationship between the pathologic grade of pancreatic ductal adenocarcinoma and the enhancement parameters of contrast-enhanced CT.
In this retrospective study, 42 patients (Age, mean ± SD: 62.43 ± 11.42 years) with PDA who underwent surgery after preoperative CT were selected. Two radiologists evaluated the CT images and calculated the value of attenuation at the aorta in the arterial phase and the pancreatic phase (VA and VA) and of the tumor (VT and VT) by finding out four regions of interest. Ratio between the tumor and the aorta enhancement on the arterial phase and the pancreatic phase (TAR and TAR) was figured out through dividing VT by VA and VT by VA. Tumor-to-aortic enhancement fraction (TAF) was expressed as the ratio of the difference between attenuation of the tumor on arterial and parenchymal images to that between attenuation of the aorta on arterial and pancreatic images. The Kruskal-Wallis analysis of variance and Mann-Whitney test for statistical analysis were used.
Forty-two PDAs (23 men and 19 women) were divided into three groups: Well-differentiated ( 13), moderately differentiated ( 21), and poorly differentiated ( 8). TAF differed significantly between the three groups ( = 0.034) but TAR ( = 0.164) and TAR ( = 0.339) did not. The median value of TAF for poorly differentiated PDAs (0.1011; 95%CI: 0.01100-0.1796) was significantly higher than that for well-differentiated PDAs (0.1941; 95%CI: 0.1463-0.3194).
Calculation of TAF might be useful in predicting the pathologic grade of PDA.
胰腺导管腺癌（PDA）是一种死亡率和生存时间都很高的恶性肿瘤。传统的计算机断层扫描（CT）已在全球范围内用于诊断 PDA，因为 CT 增强模式被认为与肿瘤血管生成和 PDA 的病理分级有关。
评估胰腺导管腺癌的病理分级与增强 CT 增强参数之间的关系。
在这项回顾性研究中，选择了 42 名（年龄，平均值±标准差：62.43±11.42 岁）在术前 CT 后接受手术的 PDA 患者。两名放射科医生评估了 CT 图像，并通过找出四个感兴趣区域，计算了动脉期和胰腺期主动脉（VA 和 VA）和肿瘤（VT 和 VT）的衰减值。通过将 VT 除以 VA 和 VT 除以 VA 计算出动脉期和胰腺期肿瘤与主动脉增强的比值（TAR 和 TAR）。肿瘤与主动脉增强比（TAF）表示肿瘤在动脉和实质图像上的衰减与主动脉在动脉和胰腺图像上的衰减之间的差异的比值。采用 Kruskal-Wallis 方差分析和 Mann-Whitney U 检验进行统计学分析。
42 个 PDA（23 名男性和 19 名女性）分为三组：高分化（13 例）、中分化（21 例）和低分化（8 例）。三组 TAF 差异有统计学意义（ = 0.034），但 TAR（ = 0.164）和 TAR（ = 0.339）无差异。低分化 PDA 的 TAF 中位数（0.1011；95%CI：0.01100-0.1796）明显高于高分化 PDA（0.1941；95%CI：0.1463-0.3194）。
计算 TAF 可能有助于预测 PDA 的病理分级。
