【摘要】 目的探讨术前64层螺旋CT血管造影(64-SCTA)以血管受侵程度评价胰头恶性肿瘤可切除性的临床应用价值。方法3位医生回顾性分析33例胰头恶性肿瘤的术前64-SCTA资料,将胰头恶性肿瘤对邻近血管的侵犯程度分5级,分别对动脉、静脉的受侵程度与病变的可切除性进行评估,并与详细的手术记录进行了对照。结果 3位医生评价胰头恶性肿瘤对各血管受侵程度不完全相同,但依此评价经典切除术肿瘤可切除的总体结果基本一致,P>0.05。高年资医生评价经典切除术肿瘤可切除的敏感性为78.6%,特异性为94.7%,准确性为87.9%,阳性预测值为91.7%,阴性预测值为85.7%。Kappa=0.747(P<0.001);ROC曲线下面积为0.867(P<0.001)。低年资医生评价经典切除术肿瘤可切除的敏感性为50.0%,特异性为89.5%,准确性为72.7%,阳性预测值为77.8%,阴性预测值为70.8%。Kappa=0.414(P<0.05);ROC曲线下面积为0.697(P>0.05)。结论术前64-SCTA对胰头恶性肿瘤邻近血管是否受侵、受侵程度、病变经典切除术可切除性评价的临床应用价值较高。更多还原

【Abstract】 Objective To investigate the preoperative evaluation of 64-slice spiral computed tomographical angiography(64-SCTA)to predict vascular involvement and general resectability of pancreatic head malignant tumors.Methods The material of 64-slice spiral computed tomographical angiography(64-SCTA) were retrospectively analyzed for pancreatic head malignant tumors in 33 cases by 3 doctors.Preoperative imaging findings were correlated with intraoperative and histopathologic results.Results Regarding respectability,the sensitivity,specificity,accuracy,positive predictive value(PPV),negative predictive value(NPV) of the experienced radiologist were 78.6%,94.7%,87.9%,91.7%,85.7%.Kappa value was 0.747(P<0.001).Receiver operator characteristic(ROC) analysis revealed an area under the curve(AUC) of 0.867(P<0.001).Regarding respectability,these values of the primary radiologists were 50.0%,89.5%,72.7% 77.8%,70.8%.Kappa value was 0.414(P<0.001).ROC analysis showed an AUC of 0.697(P>0.05).Conclusion 64-SCTA can provide reliable information for vascular involvement and general resectability of pancreatic malignant tumors.64-SCTA has high value in clinical application.更多还原