CT enhancement scanning and diffusion-weighted magnetic resonance imaging for differential diagnosis between chronic mass-forming pancreatitis and pancreatic carcinoma / 第二军医大学学报

ABSTRACT

Objective To explore the values of CT enhancement scanning and diffusion-weighted magnetic resonance imaging (DWI) in differential diagnosis between chronic mass-forming pancreatitis and pancreatic carcinoma. Methods The clinical data of 101 patients with pancreatic lesions (Jan. 2008 to Oct. 2012) were retrospectively analyzed. The results of abdominal CT enhancement scanning were compared with the postoperative pathological findings, and the sensitivity, specificity, accurate rate, positive predictive value, and negative predictive value of CT enhancement scanning were calculated. The CT findings of mass-forming pancreatitis and pancreatic carcinoma were compared. The size, site, shape (reinforcement levels after enhancement, calcification, pseudocyst, and dilated pancreatic duct) of the lesions, the perirenal fascia thickening, peripancreatic vessel invasion, and metastasis status were analyzed and the key diagnostic points were identified. Pancreatic DWI imaging characteristics of all the patients using b value 800 s/mm2 was analyzed and the apparent diffusion coefficient (ADC) values of the two groups were compared with normal pancreatic tissues. Results Of the 101 pancreatic lesions, 59 were pathologically diagnosed as pancreatic cancer and 42 as mass-forming pancreatitis. The sensitivity, specificity, accurate, positive predictive value, and negative predictive value of CT findings were 94. 9%, 88. 1%, 92. 1%, 91. 8%, and 92.5%, respectively. CT values before and after enhancement, calcification of pancreas and pancreatic duct, pseudocyst, dilated pancreatic duct and bile capillary, peripancreatic vessel invasion, and metastasis were of significant values for differential diagnosis between chronic mass-forming pancreatitis and pancreatic carcinoma (P< 0. 05). No significant difference in ADC values was found between chronic mass-forming pancreatitis and pancreatic carcinoma, but ADC values of chronic mass-forming pancreatitis and pancreatic carcinoma were significantly different from that of normal pancreatic parenchyma (P < 0. 01). Conclusion CT enhancement scanning can contribute to differential diagnoses between pancreatic cancer and chronic mass-forming pancreatitis, while DWI is of limited value for the differential diagnosis of the two diseases.