Abstract: Objective To evaluate the differential diagnostic value of magnetic resonance imaging (MRI) enhanced scanning, computed tomography (CT) and their combination in pancreatic cancer and chronic pancreatitis. Methods A total of 50 patients with pancreatic cancer and 65 patients with chronic pancreatitis who visited the hospital in June 2018~June 2023 were selected as the research subjects, and CT and MRI enhanced scanning were performed, and the Kappa consistency test was used to evaluate the consistency of CT, MRI and the combination of the two on the differential diagnosis results and pathological diagnosis results of pancreatic cancer and chronic pancreatitis. Results CT: Chronic pancreatitis was locally manifested as a reduction in the size of the pancreate, mostly irregular or lobulated masses with rough edges. Large, extensive,diffuse distribution of spot-like calcifications occur, and pancreatic parenchymal density is uniform or locally reduced. Pancreatic cancer is mostly manifested as the formation of a substantial mass on the basis of a locally enlarged pancreas, with smooth edges and generally no pagination; Less calcification; The gland is diffuse or locally enlarged, with equal or slightly lower density. MRI: chronic pancreatitis T1WI showed low signal, T2WI signal was mixed, and occasionally high signal; weak or no enhancement on contrast-enhanced scanning; Pancreatic cancer T1WI showed low or slightly lower signal, T2WI showed high or isoheight signal, and pancreatic bile ducts were irregularly dilated; Enhanced scanning is uneven, with low intensification. Compared with patients with chronic pancreatitis, patients with pancreatic cancer had a higher incidence of increased pancreatic size, invasion of surrounding tissues and large blood vessels, swelling of peripheral lymph nodes, irregular expansion of pancreatobiliary ducts, and lower incidence of lesion invasion of peripheral cysts, calcification of diseased tissues,and delayed intensification (P<0.05). The CT values of arterial, pancreatic and delayed phases in patients with pancreatic cancer were lower than those in patients with chronic pancreatitis (P<0.05). The accuracy rates of CT combined with MRI enhanced scan in the diagnosis of pancreatic cancer and chronic pancreatitis were 96.00% (48/50) and 96.92% (63/65), respectively, which were higher than the 74.00% (37/50), 70.77% (46/65) of CT diagnosis and 86.00% (43/50) and 75.38% (49/65) of MRI enhanced scan, and CT combined with MRI enhanced scan for differential diagnosis of pancreatic cancer. The Kappa value of chronic pancreatitis was 0.829, which was higher than that of 0.548 and 0.614 for differential diagnosis by CT and MRI enhanced scan. Conclusion CT and MRI enhanced scanning have good differential diagnostic value for pancreatic cancer and chronic pancreatitis, but the combination of the two can provide higher diagnostic efficiency.

Key words: pancreatic cancer, chronic pancreatitis, computed tomography, MRI-enhanced scanning, differential diagnosis