Preliminary Application Of Contrast-Enhanced 3.0 T MRI And 64-Multirow Detector CT In Diagnosis Of Patients And Vascular Involvement In Pancreatic Carcinoma

Objective: The purpose of this study was to assess the values of enhancement CT and enhancement MRI for discrimination of pancreatic carcinoma and major vascular involvement.Methods: Sixty patients proven by clinical diagnosis or pathology(45 patients with pancreatic cancer,15 patients with mass pancreatitis or autoimmune pancreatitis)with enhancement CT and enhancement MRI were enrolled.Two radiologists using PACS system assessed the images(enlargement of the pancreas or local swelling;substantial mass,moderate enhancement in arterial phase enhancement,continued enhancement in delayed phase;the boundary of tumor and normal pancreas being visible and slightly blurred;expansion of the pancreatic duct)independently for the comparison of value of the two methods.Nine patients with surgical pathology-proven underwent surgery.Two radiologists assessed the 63 blood vessels of the 9 patients.The diagnostic performance of the two methods was assessed by means of receiver operating characteristic.Youden index were calculated based on the critical point of 1-3 point respectively.Results: The accuracy of enhancement MRI(AUC = 0.919)was significantly higher than the enhancement CT(AUC = 0.848).The sensitivity were 0.822,0.644 and the specificity were 0.867,0.933.There was statistically significant difference in diagnosis of pancreatic carcinoma(P=0.014< 0.05)or in characters of enhancement pattern(P=0.011<0.05)..About evaluation of vascular involvement,enhanced MRI(AUC = 0.928)was more accurate than enhancement CT(AUC = 0.845).The sensitivity were 0.909,0.773 and the specificity were 0.909,0.902.When a tipping point,with 1-3 points,enhanced MRI of Youden index were 0.565,0.86,0.112;Enhanced CT were 0.446,0.675,0.087.Conclusion: Both enhanced CT and MRI have high reliability in diagnosis of pancreatic cancer and major vascular involvement.Enhancement MRI is more accurate than enhancement CT.Which is more reliable to judge whether the blood vessels are involved.when 2 points was considered as critical point.