| 杨锐,宋奇科,刘媛媛,钟时玲,石喻.术前增强CT预测胰头癌侵犯肠系膜上静脉/门静脉[J].中国医学影像技术,2022,38(4):550~554 |
| 术前增强CT预测胰头癌侵犯肠系膜上静脉/门静脉 |
| Preoperative enhanced CT in predicting pancreatic head cancer involving superior mesenteric vein/portal vein |
| 投稿时间：2021-07-09 修订日期：2021-11-07 |
| DOI：10.13929/j.issn.1003-3289.2022.04.017 |
| 中文关键词: 胰腺肿瘤 肿瘤转移 体层摄影术,X线计算机 预测 |
| 英文关键词:pancreatic neoplasms neoplasm metastasis tomography, X-ray computed forecasting |
| 基金项目:国家自然科学基金面上项目（82071885）。 |
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| 中文摘要: |
| 目的 评估术前增强CT预测胰头癌侵犯肠系膜上静脉（SMV）/门静脉（PV）及其程度的价值。方法 回顾性分析166例经病理证实的胰头（含钩突部）癌患者，评估术前门静脉期CT所示肿瘤直径、边界，肿瘤与静脉（SMV/PV）接触界面（TVI） （0/ ≤ 180°/>180°）、肿瘤与静脉（SMV/PV）接触长度（LIV），有无静脉壁不规则、静脉管腔狭窄，静脉管腔闭塞及SMV泪滴样变形。以logistic回归分析观察胰头导管腺癌侵犯SMV/PV的影响因素，建立联合参数预测模型，以受试者工作特征（ROC）曲线评估其预测SMV/PV受侵及其程度的效能。结果 166例中，66例SMV/PV受侵，其中轻度及中重度各33例。logistic回归分析显示，TVI>180°、LIV>2 cm及静脉管腔狭窄为SMV/PV受累的独立危险因素（P均<0.05），以联合参数模型1预测胰头癌侵犯SMV/PV的敏感度为75.84%，特异度为91.21%，曲线下面积（AUC）为0.884；TVI>180°、LIV>2 cm为SMV/PV中重度受累的独立危险因素（P均<0.05），以联合参数模型2预测胰头癌中重度侵犯SMV/PV的敏感度为84.84%，特异度为83.91%，AUC为0.885。结论 术前增强CT可有效预测胰头癌侵及SMV/PV及其程度。 |
| 英文摘要: |
| Objective To observe the value of preoperative enhanced CT in predicting pancreatic head carcinoma involving superior mesenteric vein (SMV)/portal vein (PV). Methods Preoperative enhanced CT data of 166 patients with pancreatic head ductal adenocarcinoma (including the uncinate process) confirmed by pathology were retrospectively analyzed. Tumor diameter, tumor boundary, tumor-vein interface (TVI), length of involved vein (LIV), regular/irregular venous wall, venous narrow nor not narrow, venous lumen opened or occluded and SMV teardrop-like deformation on the portal vein phase CT images were evaluated. The impact factors on SMV/PV invasion of pancreatic head carcinoma were analyzed with logistic regression, then combined prediction models were established, and receiver operating characteristic (ROC) curves were used to evaluate the efficacy of models for predicting SMV/PV involvement and its degree. Results Among 166 patients, 66 were found with SMV/PV involvement, including 33 of mild and 33 cases of moderate-severe involvement. Logistic regression analysis showed that, TVI>180°, LIV>2 cm and venous lumen stenosis were independent risk factors of SMV/PV involvement of pancreatic head carcinoma (all P<0.05), and the sensitivity of combined model 1 for predicting SMV/PV involvement was 75.84%, with specificity of 91.21% and the area under the curve (AUC) of 0.884. TVI>180ånd LIV >2 cm were independent risk factors of moderate-severe SMV/PV involvement of pancreatic head carcinoma, the sensitivity of combined model 2 for predicting moderate-severe SMV/PV involvement of pancreatic head carcinoma was 84.84%, with specificity of 83.91% and AUC of 0.885. Conclusion Preoperative enhanced CT could effectively predict SMV/PV involvement and its degree of pancreatic head carcinoma. |
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