Diagnostic value of contrast -enhanced computed tomography for mass -forming pancreatitis and pancreatic ductal adenocarcinoma
ZHANG Rui,TIAN Chun-jiang,ZHANG Xiang
Tianjin Nankai Hospital,Tianjin 300100, China
Abstract:
Objective To investigate the value of contrast-enhanced computed tomography (CT) features in distinguishing mass-forming pancreatitis (MFCP) from pancreatic ductal adenocarcinoma (PDAC). Methods 24 patients with pathologically confirmed MFCP and 38 patients with PDAC in our hospital from January 2019 to February 2023 were included in this study. Clinical data and CT imaging features, including tumor location,margin, main pancreatic duct dilatation, bile duct dilatation, vascular invasion, cystic necrosis, pancreatic atrophy, calcification, pancreatic duct stone, tumor -to -pancreas enhancement ratio of the two lesions were evaluated. Results Age, the incidence of yellow urine or icterus and bile duct dilatation，vascular invasion in PDAC was higher than MFCP, while abdominal pain, pancreatic duct stone, pancreatic calcification were lower(P<0.05). Tumor-to-pancreas enhancement ratio in MFCP was significantly higher than that in PDAC in arterial phase, portal venous phase and parenchymal phase (P<0.05). Tumor-to-pancreas enhancement ratio in arterial phase, portal venous phase and parenchymal phase was significantly higher than that in plain scan in MFCP(P<0.05). Tumor -to -pancreas enhancement ratio in the portal phase has the highest diagnostic value in differentiating MFCP from PDAC, with sensitivity, specificity and a cut-off value of 87.5%, 94.7% and 0.825,respectively. Conclusion Tumor-to-pancreas enhancement ratio in the portal phase has a high diagnostic value in differentiating MFCP from PDAC. The PDAC should be highly vigilant when the ratio of tumor/pancreatic enhancement in the portal phase is less than 0.825.
