The Value Of Dual-layer Detector Spectral CT In Differential Diagnosis Between Pancreatic Cancer And Mass-forming Pancreatitis

Objective:To investigate the differential diagnostic value of dual detector spectral CT in pancreatic ductal adenocarcinoma(PDAC)and chronic mass-forming pancreatitis(CMFP).Methods:A retrospective analysis was made of 83 cases of patients with pancreatic masses confirmed by pathology and/or followed up by double detector spectral CT abdominal enhancement examination,including 58 cases of pancreatic cancer and 25 cases of mass pancreatitis.First,the CT quantitative parameters(routine CT values in arterial and venous phases,40 Ke V virtual single energy CT values,normalizing iodine concentration values,etc.),qualitative signs(focus necrosis,pancreatic duct truncation,pancreatic bile duct dilation,etc.)and related clinical data of the two groups of patients were analyzed by single factor comparison.Then those with statistically significant differences(P<0.05)were included in binary logistic regression for multivariate analysis to determine the independent predictors for the diagnosis of pancreatic cancer,Finally,the diagnostic performance of the subjects was analyzed by ROC curve.Results:There was statistical significance in the comparison of no history of pancreatitis,pancreatic duct truncation,40 Kev CT value in arterial phase,and standardized iodine concentration(NIC)value in venous phase,which can be used as an independent predictor for the differential diagnosis of pancreatic cancer and chronic mass-forming pancreatitis.The specificity,sensitivity and area under the ROC curve(AUC)of the combined differential diagnosis of the above factors were 94.8%,100% and 0.989[95% confidence interval(CI)0.970～1.000],respectively.Conclusion:The combination of quantitative parameters and qualitative signs of dual detector spectral CT is helpful to differentiate pancreatic cancer from chronic mass pancreatitis.