目的

对比磁共振成像（MRI）与计算机断层扫描（CT）在诊断胰腺导管腺癌（PDAC）的胰周血管侵犯中的应用价值。

方法

选择2019 年6 月至2022 年5 月中山大学附属第一医院82例经手术切除或开腹探查且病理诊断为PDAC 的患者，根据手术结果证实其中发生血管侵犯25 例，无血管侵犯57 例。患者均进行MRI 与CT 检查，分别评估两种检查方式对胰周动、静脉侵犯的诊断效能，并对比单用一种检查方式与联合两种检查的评估结果的诊断差异。

结果

MRI 和CT 评估静脉侵犯时的敏感度和特异度差异无统计学意义，而MRI 对发生静脉侵犯的区分能力优于CT（P＜0.05）；MRI 和CT 评估动脉侵犯时的敏感度和判断能力差异无统计学意义，而MRI 特异度优于CT（P＜0.001）；MRI 联合CT 后评估的敏感度提高，对血管侵犯的判断能力优于CT（P＜0.05）。

结论

MRI 较CT 更适用于评估PDAC 胰周静脉侵犯，MRI 联合CT 可以提高对PDAC 血管侵犯的诊断敏感度。

Objective

To compare the value of magnetic resonance imaging （MRI） and computed tomography （CT） in the diagnosis of peripancreatic vascular invasion in pancreatic ductal adenocarcinoma（PDAC）.

Methods

Eighty-two patients with PDAC diagnosed pathologically by surgical resection or laparotomy in the First Affiliated Hospital of Sun Yat-sen University from June 2019 to May 2022 were selected.Among them， 25 cases with vascular invasion and 57 cases without vascular invasion were confirmed according to the surgical results.All patients were examined by MRI and CT.The diagnostic efficacy of the two modalities for peripancreatic arterial and venous invasion was evaluated separately.The diagnostic differences between the results of one modality alone and the combination of the two modalities were compared.

Results

The differences in sensitivity and specificity between MRI and CT in assessing venous invasion were not statistically significant， while the aera under the curve （AUC） of MRI was better than CT （P＜0.05）； the differences in sensitivity and judgment between MRI and CT in assessing arterial invasion were not statistically significant， while the specificity of MRI was better than that of CT （P＜0.001）.When MRI was combined with CT， the sensitivity of assessment was increased and the judgment ability of vascular invasion was better than CT （P＜0.05）.

Conclusion

MRI is more suitable than CT for assessing peripancreatic venous invasion in PDAC， and combination of MRI with CT can improve the diagnostic sensitivity of vascular invasion in PDAC.