等密度胰腺癌的多层螺旋CT诊断  

MSCT diagnosis of isoattenuating pancreatic adenocarcinoma

作　　者：许相丰[1] 杨津毅[1] 张增利[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》2007年第7期468-470,共3页Journal of China Clinic Medical Imaging

摘　　要：目的:分析等密度胰腺癌的多层螺旋CT(MSCT)表现,探讨MSCT曲面重组(CPR)的诊断价值。方法:回顾62例经手术病理或临床证实的胰腺癌患者的MSCT表现,肉眼观察在平扫和双期增强扫描肿瘤与正常胰实质的密度对比,并用CPR显示胰腺、胰管和胆总管的全貌。结果:62例中5例(8.1%)肿瘤在平扫和增强扫描肉眼看均呈等密度,肿瘤全部位于胰头部,间接征象有“胰管中断征”(5例)、“双管征”(4例)、胰腺头形态异常(4例)和远侧胰实质的萎缩(1例)。其余57例肿瘤在增强扫描肉眼可见明显低密度肿块。结论:少数胰腺癌肉眼看呈等密度,“胰管中断征”、“双管征”和胰腺轮廓的异常是诊断的重要间接征象,CPR有利于显示胰腺、胰管和胆管的全貌,对诊断有很大价值。Objective： To analyze the findings of isoattenuating pancreatic adenocarcinoma on multi-slice spiral CT（MSCT） and evaluate the value of curved planar reformations（CPR） in diagnosis. Methods： The CT findings of 62 pancreatic adenocarcinoma proved by surgery or clinical materials were analyzed retrospectively. The contrast relative to pancreas was observed on the basis of visual inspection during nonenhanced and biphasic enhanced scanning. CPR were generated along pancreatic duct and common bile duct. Results： Of 62 patients, 5 （8.1%） had isoattenuating tumors on the basis of visual inspection during nonenhanced and biphasic enhanced scanning. The secondary signs of the five patients included an ＂interrupted pancreatic duct＂ sign （n=5）, ＂double duct＂ sign （n=4）, contour abnormality of the pancreatic head （n--4）, and atrophic distal pancreatic parenchyma （n=l）. The remaining 57 patients had visible hypoattenuating tumors on enhance CT. Conclusion： A small number of pancreatic adenocarcinomas were deemed isoattenuating on the basis of visual inspection, indirect signs such as ＂interrupted pancreatic duct＂ sign, ＂double duct＂ sign, and contour deformity of the pancreas are important indicators for the presence of tumor. CPR help to display the whole view of pancreas, pancreatic duct and common bile duct, and help to confirm the presence of tumor.

关 键 词：胰腺肿瘤 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]