螺旋CT双期增强扫描在胰腺癌诊断中的价值  

Dual-phase helical CT in the diagnosis of the pancreatic carcinoma

作　　者：蒲红[1] 宋彬[1] 

机构地区：[1]四川大学华西医院放射科,四川成都610072

出　　处：《实用医学影像杂志》2006年第1期27-29,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨螺旋CT双期增强扫描在胰腺癌诊断中的价值。方法31例胰腺癌患者均行螺旋CT双期增强扫描,扫描延迟时间分别定为30s(胰腺期)和70s(门脉期),造影剂用量100mL(非离子型),高压注射器团注,速率2.5mL/s～3mL/s。观察并比较肿瘤及正常胰腺在两期的增强情况。根据CT征象对肿瘤可切除性进行评价,并与手术结果比较。结果31例中肿瘤位于胰头颈部19例,钩突部9例,体部3例。发现小胰腺癌3例,直径均小于2cm。肿瘤一胰腺对比胰腺期与门脉期相比有显著性差异(P<0.01)。胰腺期肿瘤增强后呈相对低密度,为特征性CT表现。胰周大血管受侵占不可切除性肿瘤的占62%,胰周小静脉迂曲扩张占32%,肝脏、淋巴结转移灶占38%。结论螺旋CT双期增强扫描对胰腺癌的诊断及可切除性评价具有非常重要的临床价值。Objective To evaluate the value of dual - phase helical CT in the diagnosis of the pancreatic carcinoma. Methods Dualphase helical CT was perforemed on 31 patients with pancreatic carcinoma. Pancreatic phase and portal venous phase began at 30 seconds and 70 seconds after the start of the injection respectively with 100 mL, intravenous contrast material injected at rate of 2.5 mL/s ～ 3 mL/s. the enhancement finding of normal pancreas and tumor during the two phases was observed and compared. The assessment of tumor resectability based on CT finding was compared with surgical and histopathologic results. Results 19 of 31 cases were located in the heads or necks, 9 cases in the processus uncinatus, 3 cases in the bodies. 3 cases small pancreatic carcinoma were found. Tumor-pancreas contrast was significantly greater in pancreatic - phase than in portal venous - phase. All of them showed low density with peripheral enhanced on the enhanced images. It was identified that 62 % of unresectable cases with major peripancreatic vessels invasion, 32 % with small peripancreatic veins dilation, and 38 % metastatic hepatic neoplasms and metastatic lymphonodi. Conclusion Dual - phase enhanced spiral CT have very important values for the diagnosis and the assessment of resectability of the pancreatic carcinoma.

关 键 词：胰腺肿瘤 体层摄影术 X线计算机 增强扫描 可切除性评价 

分 类 号：R735.9[医药卫生—肿瘤]