Analysis Of The Diagnostic Value Of Different Imaging Studies On Ampullary Carcinoma

Objective:To analyze the value of different imaging tests in the diagnosis of vater ampulla carcinoma(VPC),which is helpful for the diagnosis and differential diagnosis of ampullary carcinoma and to provide assistance for surgical treatment.Methods:From January 2010 to December 2017,69 patients with ampullary carcinoma were selected from the first affiliated hospital of kunming medical university for surgical treatment and postoperative diagnosis.The coincidence rate of ultrasound,CT,MRI,MRCP,ERCP,endoscopic ultrasonography,PET/CT in the diagnosis of ampullary carcinoma was analyzed retrospectively.Pairwise comparison was conducted between different imaging examinations and chi-square test was used to determine whether the difference was statistically significantResults:Among the 69 patients,68 underwent b-ultrasonography,24 were diagnosed with the diagnosis,and the diagnostic coincidence rate was 35.3%.There were 59 CT examinations,31 cases of diagnosis and 52.5%of diagnostic conformance.There were 69 routine MRI examinations,33 cases were diagnosed,and the diagnostic coincidence rate was 47.8%.There were 66 MRCP tests,32 cases were diagnosed,and the diagnostic coincidence rate was 48.5%.There were 18 routine ERCP tests,14 cases were confirmed,and the diagnostic coincidence rate was 77.8%.There were 21 cases of EUS examination,17 cases were diagnosed and the diagnostic coincidence rate was 81.0%.There were 23 routine PET/CT examinations,19 diagnostic conformance and 82.6%diagnostic conformance.The diagnostic coincidence rate of various imaging examinations was compared with chi-square test,and the difference was statistically significant(P<0.05).Conclusion:First,ultrasound should be the first choice for preliminary screening of ampullary carcinoma.Second,enhanced CT examination should be further selected when ultrasonography is used to detect lumps in the ampullary abdomen or the hooked process of the head of the pancreas.Third,MRI combined with MRCP should be further selected when no abdominal mass was found in the ampulla but the common bile duct and main pancreatic duct were slightly dilated.Fourth,if the diagnosis of ampulla abdominal mass is still difficult or the preoperative tumor stage is uncertain,EUS examination should be routinely selected.Fifth,PET/CT examination should be actively promoted when patients have other tumor histories or suspect distant metastasis of ampullary carcinoma.Sixth,ERCP inspection is generally not recommended,and is selected as appropriate in special cases.