为比较MRI与CT诊断胰管腺癌（PDAC）血管侵犯的诊断准确性而进行系统回顾。通过搜寻MEDLINE、EMBASE、Cochrane Central和Scopus数据库，截止到2021年12月，收集了对同一患者进行MRI与CT比较评估PDAC病理学确认的血管侵犯的诊断准确性研究。以手术切除或探查手术作为首选参考标准。运用《诊断准确性研究-比较工具》进行数据抽取、偏倚风险和适用性评估。采用带95%置信区间（95％CI）的双变量随机效应荟萃分析和荟萃回归。共选取3项研究，评估了107名患者中474个无血管侵犯的血管和65个有血管侵犯的血管。所有患者均使用MRI≥1.5 T和胰腺方案CT进行图像化。结果显示，MRI和CT在诊断PDAC血管侵犯方面没有差异，MRI/CT的敏感性（95％CI）分别为71％（47-87％）/74％（56-86％），特异性分别为97％（94-99％）/ 97％（94-98％）。偏倚来源包括仅有CT子集的选择性偏差和未能在手术确认疾病无法切除的患者中进行确认的验证偏差。在进行分期前没有患者接受新辅助治疗。基于有限数据，MRI与胰腺方案CT在PDAC血管侵犯评估方面未出现差异。MRI可能是某些患者胰腺方案CT的替代方法，特别是那些已经进行了单相CT检查的患者。需要进行更大规模和较新的队列研究来降低偏差风险，并包括接受新辅助治疗的患者。腹部MRI与胰腺方案CT在评估PDAC血管侵犯方面的表现相似，表明对于其中一些患者使用MRI进行局部分期是足够的。需要更多数据，包括接受新辅助治疗的患者，使用更大、更近期的队列进行比较MRI和CT的PDAC分期的诊断性能。©2023年，作者(们)独家授权欧洲放射学会使用。

To perform a systematic review comparing the diagnostic accuracy of MRI vs. CT for assessing pancreatic ductal adenocarcinoma (PDAC) vascular invasion.MEDLINE, EMBASE, Cochrane Central, and Scopus were searched until December 2021 for diagnostic accuracy studies comparing MRI vs. CT to evaluate vascular invasion of pathologically confirmed PDAC in the same patients. Findings on resection or exploratory laparotomy were the preferred reference standard. Data extraction, risk of bias, and applicability assessment were performed by two authors using the Quality Assessment of Diagnostic Accuracy Studies-Comparative Tool. Bivariate random-effects meta-analysis and meta-regression were performed with 95% confidence intervals (95% CI).Three studies were included assessing 474 vessels without vascular invasion and 65 with vascular invasion in 107 patients. All patients were imaged using MRI at ≥ 1.5 T and a pancreatic protocol CT. No difference was shown between MRI and CT for diagnosing PDAC vascular invasion: MRI/CT sensitivity (95% CI) were 71% (47-87%)/74% (56-86%), and specificity were 97% (94-99%)/97% (94-98%). Sources of bias included selection bias from only a subset of CT patients undergoing MRI and verification bias from patients with unresectable disease not confirmed on surgery. No patients received neoadjuvant therapy prior to staging.Based on limited data, no difference was observed between MRI and pancreatic protocol CT for PDAC vascular invasion assessment. MRI may be an adequate substitute for pancreatic protocol CT in some patients, particularly those who have already had a single-phase CT. Larger and more recent cohort studies at low risk of bias, including patients who have received neoadjuvant therapy, are needed.Abdominal MRI performed similarly to pancreatic protocol CT at assessing pancreatic ductal adenocarcinoma vascular invasion, suggesting local staging is adequate in some patients using MRI. More data are needed using larger, more recent cohorts including patients with neoadjuvant treatment.• Based on limited data, no difference was found between MRI and pancreatic protocol CT sensitivity and specificity for diagnosing PDAC vascular invasion (p = 0.81, 0.73 respectively). • Risk of bias could be reduced in future PDAC MRI vs CT comparative diagnostic test accuracy research by ensuring all enrolled patients undergo both imaging modalities being compared in random order and regardless of the findings on either modality. • More studies are needed that directly compare the diagnostic performance of MRI and CT for PDAC staging after neoadjuvant therapy.© 2023. The Author(s), under exclusive licence to European Society of Radiology.