多层螺旋CT三期增强扫描对胰腺癌诊断价值  

The value of multi-phase enhanced scan of MSCT in diagnosis of pancreatic carcinoma

作　　者：征锦[1] 姜岸秋[1] 傅剑雄[1] 施斌斌[1] 陈文新[1] 陈明祥[1] 吴志远[1] 

机构地区：[1]江苏省苏北人民医院CT室,江苏扬州225001

出　　处：《医学影像学杂志》2004年第12期1001-1003,共3页Journal of Medical Imaging

摘　　要：目的 :评价多层螺旋CT多期增强扫描对胰腺癌的诊断价值。方法 :4 8例胰腺癌患者行多层螺旋CT多期扫描 ,先作平扫 ,再以 3ml/s的速度通过肘静脉团注对比剂 (碘海醇 ) 90～ 10 0ml,分别行动脉期 (注射后 2 5～ 2 5s) ,门脉期 (70～ 85s)及平衡期 (180～ 2 0 0s)扫描 ,层厚 5mm。分别观察平扫及增强各期正常胰腺的形态、密度的变化 ,胰腺癌的形态、密度的变化以及转移瘤的发现率。结果 :多层螺旋CT扫描速度快 ,检查时间短 ,密度分辨率高 ,可在一次屏气下完成腹部的CT扫描。正常胰腺血供丰富 ,增强时动脉期、门脉期强化很明显 ,而胰腺癌为相对乏血管 ,增强时动脉期、门脉期强化不明显 ,呈低密度区 ,动脉期扫描正常胰腺和癌肿的密度差异较大 ,门脉期及平衡期可兼顾显示胰腺癌及胰外转移瘤。结论 :胰腺癌的多层螺旋CT检查应以三期增强扫描作为常规 ,动脉期对胰腺癌特别是小胰腺癌的诊断有重要的价值。Objective:To evaluate diagnostic value of multi-phase enhanced scan of MSCT in pancreatic carcinoma.Methods:48 patients with pancreatic carcinoma were performed scan with MSCT before and after injection of 100ml contrast materials (lohexol). We classify enhanced scan in three phases: the arterial phase (25～25sec after injection), the portal venous phase (70～85sec after injection) and the balance phase (180～200sec after injection). The scan slice is 5mm. Then we observe the change of shape and density of normal pancreas and pancreatic carcinoma in plain scans and each-phase enhanced scans.Results:MSCT can finish one abdomen scan in one breath-hold with fast scan, short time and high-distinguished density. The normal pancreas has a good arterial supply and shows significant enhancement in the arterial phase and portal venous phase while pancreatic carcinoma does not. The change of shape of pancreas is not main evidence in diagnosis of pancreatic carcinoma, especially small pancreatic carcinoma. In the arterial phase the density between normal pancreas and pancreatic carcinoma is very different and in the portal venous and balance phase both pancreatic carcinoma and metastasis are displayed.Conclusion:Multi-phase enhanced scan should be a normal in MSCT of pancreatic carcinoma and the arterial phase is more valuable in diagnosis of pancreatic carcinoma, especially small pancreatic carcinoma.

关 键 词：胰腺癌 体层摄影术 X线计算机 

分 类 号：R735.9[医药卫生—肿瘤] R814.42[医药卫生—临床医学]