目的 分析多层螺旋CT(MSCTV)和 磁共振成像(MRI)在胰腺肿块中的应用价 值，为今后提高胰腺癌检出率提供参考依 据。方法 采用回顾性研究，分析我院接 受治疗的经病理证实的40例胰腺癌患者归 为胰腺癌组，将同期收治的60例胰腺炎患 者归为胰腺炎组。均行MSCT扫描和MRI扫 描，观察胰腺炎与胰腺癌在MSCT下的影像 特征分布情况，总结胰腺癌的MSCT影像特 征；对比胰腺癌与胰腺炎在不同扫描期CT 值；观察MRI胰腺癌影像特征，以病理结 果为准记录MSCT和MRI诊断情况，记录假 阳性、假阴性；计算MSCT和MRI诊断胰腺 癌的特异度、敏感度、符合率；记录MSCT 和MRI对胰腺癌分期结果。结果 ①胰腺炎 与胰腺癌MSCT影像特征对比，胰腺癌组密 度异常率、局限性增大率、胰腺弥漫性增 大率、非肿块型不均匀强化率、扩张胰管 贯通病变区率较胰腺炎组低，结节或肿块 持续弱强化率、胰周淋巴结增大率、胰 周血管侵袭性改变率均较胰腺炎组高，P ＜0.05；胰腺癌平扫胰腺形态不规则、肿 大，病灶密度不均匀，增强扫描早期胰腺 实质内低密度影。②胰腺癌组患者CT值在 各增强扫描期均高于对照组，P＜0.05。 ③MRI确诊的胰腺癌患者胰腺肿块均为 T1W1略低或低信号，T2WI为混杂信号或略 高信号；肿瘤浸润胰周则周边脂肪为高信 号，有低信号条纹影。④CT出现5例假阳 性和8例假阴性；MRI出现5例假阳性和2 例假阴性；MRI诊断敏感度、符合率、特 异度与MSCT比较差异无统计学意义，P＞ 0.05。⑤病理检查早期为11例，进展期为 49例；MSCT确诊早期共7例，进展期共42 例；MRI检查早期8例，进展期45例，MSCT 与MRI比较，P＞0.05。结论 MSCTA与MRI 在胰腺炎和胰腺癌这类胰腺肿块鉴别中特 异度、敏感性、符合率相当，但二者各具 优势，均为较好的诊断方法，具体应用应 结合医师建议和患者需求选择，必要时通 过联合使用将能结合二者优势。

Objective To analyze the application value of multi-slice spiral CT (MSCT) and magnetic resonance imaging (MRI) in the diagnosis of pancreatic masses, and provide reference for improving the detection rate of pancreatic cancer in the future. Methods A retrospective study was conducted to analyze 40 patients with pancreatic cancer who were confirmed by pathology in the hospital. The patients with pancreatitis were classified as 60 patients with pancreatitis group. MSCT scan and MRI scan were performed to observe the distribution of pancreatitis and pancreatic cancer under MSCT. The characteristics of MSCT in pancreatic cancer were summarized. The CT values of pancreatic cancer and pancreatitis were compared. The characteristics of pancreatic cancer under MRI were observed. The pathological results were used to record the diagnosis of MSCT and MRI, and the false positive and false negative were recorded. The specificity, sensitivity and coincidence rate of diagnosis of pancreatic cancer by MSCT and MRI were calculated. The staging results of pancreatic cancer were recorded by MSCT and MRI. Results 1.The characteristics of pancreatitis and pancreatic cancer MSCT imaging, pancreatic cancer group density abnormal rate, localized rate of enlargement, pancreatic diffuse enlargement rate, non-tumor uneven enhancement rate, dilated pancreatic duct penetrating lesion rate compared with pancreatitis The group was low, the rate of weak weakening of nodules or lumps, the rate of peri-pancreatic lymph node enlargement, and the rate of peri-pancreatic vascular invasion were higher than those of pancreatitis group, P<0.05. Pancreatic cancer was irregular, enlarged, and lesions. The density is uneven, enhancing the low-density shadow of the pancreas in the early stage of scanning. 2 The CT value of patients with pancreatic cancer was higher than that of the control group at each enhanced scan period, P<0.05. The pancreatic masses of pancreatic cancer patients diagnosed by 3MRI were slightly lower or lower than T1W1, T2WI was mixed signal or slightly higher signal; the peripheral fat of tumor infiltrating pancreas was high signal and had low signal fringe. There were 5 false positives and 8 false negatives in 4CT. 5 false positives and 2 false negatives in MRI; there was no significant difference in MRI diagnostic sensitivity, coincidence rate, specificity and MSCT, P>0.05. 5 The pathological examination was 11 cases in the early stage and 49 cases in the advanced stage. There were 7 cases in the early diagnosis of MSCT, 42 cases in the advanced stage, 8 cases in the early stage of MRI, and 45 cases in the advanced stage. The MSCT was compared with MRI, P>0.05. Conclusion The specificity, sensitivity and coincidence rate of MSCTA and MRI in the identification of pancreatic masses such as pancreatitis and pancreatic cancer are comparable, but both have their own advantages. They are all good diagnostic methods. The specific application should be combined with physician recommendations and patient needs. The choice, if necessary through joint use, will combine the advantages of both.