| Citation: |
DONG Junqiang, XIE Fei, ZHANG Zhixiang, JIA Fang. Differential diagnosis of pancreatic cancer and pancreatitis by multi-slice spiral CT and MRI[J]. Journal of Clinical Medicine in Practice, 2023, 27(9): 8-12. DOI: 10.7619/jcmp.20230321
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To explore the value of multi-slice spiral CT and MRI in differential diagnosis of pancreatic cancer and pancreatitis.
A total of 45 patients with pancreatic cancer and 60 patients with pancreatitis were selected. All the patients were conducted with multi-slice spiral CT and MRI scan, and the accuracy rates of multi-slice spiral CT, MRI and multi-slice spiral CT combined with MRI in the differential diagnosis of pancreatic cancer and pancreatitis were compared based on pathological results as the gold standard; CT values of pancreatic cancer and pancreatitis in arterial, pancreatic and portal phases were compared; the imaging features of pancreatic cancer and pancreatitis were compared, including increased pancreatic volume, enlargement of peripheral lymph nodes, invasion of the lesion into the surrounding tissues and large blood vessels, calcification within the lesion, involvement of peripheral cysts, irregular dilatation of the pancreatic and bile ducts, and arterial enhancement.
Pathological examination showed that there were 45 cases of pancreatic cancer and 60 cases of pancreatitis; the multi-slice spiral CT examination showed that there were 34 cases of pancreatic cancer (the diagnostic accuracy rate was 75.56%) and 46 cases of pancreatitis (the diagnostic accuracy rate was 76.67%); the MRI examination showed that there were 35 cases of pancreatic cancer (the diagnostic accuracy rate was 77.78%) and 47 cases of pancreatitis (the diagnostic accuracy rate was 78.33%); the multi-slice spiral CT combined with MRI showed that there were 44 cases of pancreatic cancer (the diagnostic accuracy was 97.78%) and 58 cases of pancreatitis (the diagnostic accuracy was 96.67%). The accuracy of multi-slice spiral CT combined with MRI in the differential diagnosis of pancreatic cancer and pancreatitis was significantly higher than that of single multi-slice spiral CT and MRI (P < 0.05); CT values at arterial, pancreatic and portal phases in patients with pancreatic cancer were significantly lower than those in patients with pancreatitis (P < 0.05); the incidence rates of pancreatic volume enlargement, peripheral lymph node enlargement, and lesion invasion into peripheral tissues and great blood vessels in patients with pancreatic cancer were 73.33%, 51.11% and 66.67%, which were significantly higher than 26.67%, 0% and 35.00% in patients with pancreatitis (P < 0.05); the incidence rates of the intra-lesion calcification, lesion involvement of peripheral cysts, irregular dilatation of pancreatic bile duct, and arterial enhancement in patients with pancreatic cancer were 33.33%, 6.67%, 11.11% and 24.44% respectively, which were significantly lower than 75.00%, 28.33%, 45.00% and 60.00% in patients with pancreatitis (P < 0.05).
The accuracy of multi-slice spiral CT combined with MRI in the differential diagnosis of pancreatic cancer and pancreatitis is higher than that of single multi-slice spiral CT and MRI, and there are differences in CT values and imaging characteristics between pancreatic cancer and pancreatitis at different scanning stages.
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