作　　者： (郝利国）; (崔红升）; (孟鑫）; (张淑丽）; (王梓旭）; (周蕾）; (陈曲）; (申洪远）; (黄钰）;

机构地区： 齐齐哈尔医学院医学技术学院,161000

出　　处： 《临床放射学杂志》 2017年第8期1129-1133,共5页

摘　　要： 目的探讨PET/MR检查技术在评估胰腺癌肿瘤可切除性中的应用价值。方法选取2015年1月至2016年1月本院经病理证实的胰腺癌患者50例作为研究对象。所有患者均行18FDG-PET/MRI及增强MRI检查。根据患者的PET/MRI、MRI影像资料分MRI组、PET/MRI组、MRI结合PET/MRI组,对胰腺癌的可切除性分别进行评估,依据患者临床结局及预后对比分析三组在胰腺癌可切除性评估中的应用价值。对各组评估结果之间的差异采用χ~2检验。结果 PET/MRI与增强MRI对肿瘤不可切除性比较,(χ~2=4.708,P=0.043),具有显著性差异。增强MRI与PET/MRI评估结果比较,在诊断灵敏度(χ~2=5.103,P=0.037)、特异度(χ~2=6.818,P=0.015)、阳性预测值(χ~2=5.531,P=0.031)具有统计学意义(P<0.05)。增强MRI与联合检查评估结果在诊断灵敏度(χ~2=8.589,P=0.006)、准确度(χ~2=5.647,P=0.028)、阳性预测值(χ~2=7.354,P=0.011)、阴性预测值(χ~2=12.355,P=0.001)比较具有统计学意义(P<0.05)。PET/MRI与联合检查在评估结果比较中阴性预测值(χ~2=4.504,P=0.048)具有统计学意义(P<0.05)。增强MRI与PET/MRI评估胰腺可切除性肿瘤大小(t=-0.829,P=0.761)、不可切除性肿瘤(t=-0.902,P=0.703)比较无显著差异,肿瘤边界对于手术能(χ~2=0.188,P=0.664)否(χ~2=0.255,P=0.614)切除比较,无统计学意义(P>0.05)。结论 PET/MRI与增强MRI检查技术均可用于评估胰腺癌肿瘤可切除性,PET/MR的应用价值更高,联合应用可为临床提供更为准确的肿瘤可切除性参考信息,具有临床应用及推广价值。 Objective To discuss the value of resectability of pancreatic cancer by PET/MR. Methods 50 cases of pancreatic cancer were selected as the research objects in our hospital from January 2015 to January 2016. All patients were confirmed by pathological tests for pancreatic cancer,underwent 18FDG-PET/MR and enhanced MRI. Assessment of the resectability of pancreatic cancer according to the image materials of PET/MR and enhanced MRI was done and the clinical outcome and prognosis was compared by comprehensive analysis of the respectability of pancreatic cancer by PET/MR. χ^2 test was used to evaluate the results. Results There was significant difference between PET/MR and enhanced MR in unresectable tumors（ χ^2= 4. 708,P = 0. 043）. The positive predictive value（ χ^2= 5. 531,P = 0. 031） and the positive predictive value（ χ^2= 5. 103,P = 0. 037） and the specificity（ χ^2= 6. 818,P = 0. 015） of MR and PET/MR were statistically significant（ P〈0. 05）. Comparison between enhanced MR and combined examination and evaluation as follows ：sensitivity（ χ^2= 8. 589,P = 0. 006）,Accuracy（ χ^2= 5. 647,P = 0. 028）,Positive predictive value（ χ^2= 7. 354,P =0. 011）,Negative predictive value（ χ^2= 12. 355,P = 0. 001）,P〈0. 05. The negative predictive value（ χ^2= 4. 504,P =0. 048） between the PET/MR and the combined examination was statistically significant（ P〈0. 05）. There was no significant difference between MR and PET/MR in assessing resectable pancreatic tumor size（ t =-0. 829,P = 0. 761）,unresectable tumors（ t =-0. 902,P = 0. 703）,tumor margins for surgery（ χ-2= 0. 188,P = 0. 664）. There was no statistically significant difference between the two groups（ P〈0. 05）. Conclusion PE/MR and enhanced MR imaging techniques can be used to evaluate the respectability of pancreatic tumor,PET/MRI has the higher value. Combined application can provide more accurate value for the respectability of pancreatic cancer in the clinical setting.

关 键 词： 增强 胰腺癌 肿瘤可切除性 应用价值