壶腹周围癌影像学诊断及选择  

Imaging Examination and Choice of Cancer Around the Ampulla

作　　者：张宽学[1] 刘振堂[1] 张晓辉 王学勤[1] 

机构地区：[1]西安医科大学第二附属医院消化内科

出　　处：《实用放射学杂志》1997年第3期138-140,共3页Journal of Practical Radiology

摘　　要：为探讨壶腹周围癌影像学诊断及检查方法之选择，回顾性分析了２５例经手术病理证实的壶腹周围癌患者的影像学检查。结果：①十二指肠镜检结合逆行胰胆管造影对壶腹周围癌诊断符合率最高（８８．０％），其次为ＣＴ（５６．０％），Ｂ超（３６．０％），十二指肠低张造影（１２．０％）。②十二指肠镜检对乳头癌、十二指肠降部癌及逆行胰胆管造影对胆总管下端癌的诊断准确率最高；ＣＴ对胰头癌价值最大；Ｂ超检查对胆总管下端癌有很重要意义。低张十二指肠造影有助于发现十二指肠降部癌及胰头癌。在壶腹周围癌早期，要重视上腹饱胀不适、纳差、乏力等非特异性症状。及时行Ｂ超检查，而Ｂ超及ＣＴ还有助于显示肿瘤腔外侵犯的范围以及腹腔转移、血管受累等情况。这对于治疗方案及手术方式的选择有重要意义。In order to investigate imaging diagnosis and the choice of imaging methods of cancer around the ampulla of Vater, 25 cases cancer proved by operation and pathology were analysed. The results showed that (1) the best way to diagnose cancer around the ampulla was duodenoscope and ERCP, the accurate rate was 88.0%. While the accarate rate with CT, B-ultrosonograph and hypotonic duodenography was 56%, 36% and 12% respectively. (2) Duodenoscope had the highest accurate diagnostic rate for the cancer at papilla and desending section of duodenal, while ERCP and B-ultrosonograph were best to be used to diagnose the cancer of lower section of common bile duct, CT was useful for diagnosis of the cancer at the head of pancreas. Hypotonic duodenography is helpful for detecting the cancer at desendings part of duodenal and the head of pancreas. The authors consider that it is important to pay attention to the unspecific symptoms of the epigastrium, and B-ultrosonograph and CT should be done in order to discover cancer as early as possible.

关 键 词：壶腹周围癌 X线诊断 CT 诊断 

分 类 号：R735.804[医药卫生—肿瘤]