Abstract：Objective To explore the value of spectral CT angiography in the diagnosis of periampullary carcinoma and its preoperative staging.Methods A total of 60 patients with suspected periampullary carcinoma in Pingxiang People′s Hospital,Jiangxi Province were enrolled between July 2016 and December 2020.All underwent routine enhanced CT scan and spectral CT angiography before surgery.Using the pathological results of surgery or biopsy as the gold standard,the value of energy spectrum CT angiography in diagnosis and preoperative staging was analyzed.Results A total of 44 cases confirmed with periampullary carcinoma by surgery or biopsy,and 16 cases with periampullary inflammatory lumps.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of spectral CT angiography in the diagnosis of benign and malignant lesions were 93.18%,93.76%,93.33%,97.62% and 83.33%,greater than those of routine enhanced CT scan of 77.27%,62.50%,73.33%,85.00%,50.00%.Among the 41 patients confirmed with periampullary carcinoma by both spectral CT angiography and pathological diagnosis,there were 4 cases with T staging at stage T1,21 cases at T2,13 cases at T3 stage and 3 cases at T4.The results of spectral CT angiography showed that there were 5 cases with T staging at stage T1,20 cases at T2,12 cases at T3 stage and 4 cases at T4.The consistency Kappa values between spectral CT angiography and pathological diagnosis for stages T1,T2,T3 and T4 were 0.626,0.659,0.597 and 0.532,respectively.Conclusion The spectral CT angiography is of high diagnostic value for periampullary carcinoma,which can guide preoperative T staging of periampullary carcinoma.
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