多层螺旋CT曲面重组技术在评价胰腺癌胰周血管侵犯中的价值  

Spiral CT with curved planar reformations in the evaluation of pancreatic vessels invasion by pancreatic carcinoma

作　　者：许相丰[1] 张增利[1] 宋宏伟[1] 程宇清[1] 武广利[1] 

机构地区：[1]天津市南开医院放射科,天津300100

出　　处：《中国临床医学影像杂志》2006年第12期685-688,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:评价多层螺旋CT曲面重组(CurvedPlanarReformations,CPR)技术在判断胰腺癌胰周血管侵犯中价值。方法:回顾27例手术证实的胰腺癌病例,所有患者均行多层螺旋CT三期增强扫描,并沿着胰周大血管进行曲面重组,根据横断面图像和横断面图像结合CPR图像分别对胰周血管是否受侵进行分析。结果:27例8段共216支血管中,术中发现72支有侵犯,144支无侵犯。其中用横断面图像术前诊断64支受侵(误诊6支),152支无侵犯(漏诊14支);用横断面图像结合CPR图像术前诊断69支受侵(误诊3支),147支无侵犯(漏诊6支)。横断面图像和横断面图像结合CPR图像对判断胰周血管侵犯的敏感度、特异度、阳性预测值、阴性预测值和准确度分别为80.6%,95.8%,90.6%,90.8%,90.7%;91.7%,97.9%,95.7%,95.9%,95.8%。结论:CPR图像易于显示胰周血管的全貌和与肿瘤的关系,横断面图像结合CPR图像,有助于提高判断胰腺癌胰周血管侵犯的准确性。Objective： To evaluate multislice spiral CT （MSCT） with curved planar reformations （CPR） in detecting invasion of pancreatic vessels by pancreatic carcinoma. Methods： Twenty-seven cases of pancreatic carcinoma verified by surgery underwent contrast material-enhanced triphasic multi-slice spiral CT. CPR were generated along peripancreatic major vessels. Three readers together assessed the transverse images and the transverse images combined with CPR for detecting the presence of vascular involvement. Results： Totally, 216 vessels of 27 cases were analyzed, 72 vessels were invaded and 144 vessels were not-invaded verified by surgery. Sixty-four vessels were invaded （6 vessels were erroneously diagnosed）, 152 vessels were not-invaded（14 vessels were misdiagnosed） by the transverse images. 69 vessels were invaded （3 vessels were erroneously diagnosed）, 147 vessels were not-invaded（6 vessels were misdiagnosed） by the transverse images combined with CPR. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the transverse images and the transverse images combined with CPR for vessels invasion were 80.6%, 95.8%, 90.6%, 90.8%, 90.7%;91.7%, 97.9%, 95.7%, 95.9%, 95.8% respectively. Conclusion： CPR help to display the whole view of peripancreatic major vessels and relation to tumors, and help to improve the detection accuracy of vascular involvement by tumor.

关 键 词：胰腺肿瘤 体层摄影术 螺旋计算机 

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