基于影像学的胰腺囊性肿瘤评估模型的建立与临床应用

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1、万方数据Anevaluatingmodelforpancreaticcysticneoplasmbasedonimaginganditsclinicalapplications·ZhejiangUniversitySchoolofMedicinePurpose：Postgraduate：XiaoYongShenSupervisor：ShuSenZhengAbstractToexploreasimpleandreliablenon—invasivedistinguishingsystemforthepr

2、e．operativeevaluationofmalignancyinpancreaticcysticneoplasm(PCN)．Discoveringfactorspredictingmalignancythroughmedicalimagingandclinicalinformaticsstudy,buildingadistinguishingmodelformalignancytOassistdiagnosisandtherapyfortheclinicalpractice．Methods：Th

3、isstudyfirstenrolled锄nobservationcohortof102consecutivePCNpatients．Demographicinformation，resultsoflaboratoryexaminations，andcomputedtomography(CT)presentationswererecordedandanalyzedtOachieveadistinguishingmodel／systemformalignancy．Agroupof21patientswa

4、sthenincludedtovalidatethemodel／systemprospectively．Resuits：BasedOnthe1malignancy—relatedfeaturesidentifiedbyunivariateanalysis，aIV万方数据浙江大学硕士学位论文英文摘要distinguishingmodelformalignancyinPeNwasestablishedbymultivariateanalySis：PCNmalignantscore=2．967×elevat

5、edfastingbloodglucose(FBG)仑6．16retool／L)-4-4．496×asymmetricallythickenedwall(ormuralnodules三4rnm)-4-1．679×septumthickening仑2mm)一5．134．Withtheoptimalcut-offvalueselectedas-2．8inreferencetotheYoudenindex，theproposedsystemformalignantPeNwasestablished：sept

6、umthickening(>2mm)，asymmetricallythickenedwall(ormuralnodules>4nun)，orelevatedFBG(>6．16mmol／L，accompanyingcommonlyknownmalignantsigns)，thepresenceofatleastoneofthese3featuresindicatedmalignancyinPeN．Theaccuracy,sensitivityandspecificityofthissystemwere8

7、1．4％，95．8％and76．9％，respectively．MRlwasperformedon32patients，makiIlgcorrectpredictionofmalignancyexplicitlyinonly68．8％(22／32)．Thesubsequentprospectivevalidationstudyshowedthattheproposeddistinguishingsystemhadapredictiveaccuracyof85。7％(18／21)．Moreover,ah

8、ighermodelscore．oraggregationofthefea缸】resintheproposedsystem，indicatedahighergradeofmalignancy(carcinoma)inPeN．Conclusion：ElevatedFBG(>6．16retool／L)，asymmetricallythickenedwall(ormuralnodules>4nun)andseptumthickening(>2lnln)areo