16层螺旋CT重建技术对导管内乳头状黏液性肿瘤的诊断价值  

Diagnostic value of 16-slice computed tomography reformation technology for intraductal papillary mucinous tumor

作　　者：叶彤[1] 曾蒙苏[1] 史讯[1] 傅爱燕[1] 靳大勇[2] 纪元[3] 

机构地区：[1]复旦大学附属中山医院放射科和复旦大学上海医学院医学影像系,上海市200032 [2]复旦大学附属中山医院胰外科和复旦大学上海医学院医学影像系,上海市200032 [3]复旦大学附属中山医院病理科和复旦大学上海医学院医学影像系,上海市200032

出　　处：《中华肝胆外科杂志》2007年第12期800-803,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的评价16层螺旋CT重建技术对导管内乳头状黏液性肿瘤(intraductal papillary mucinous tumors,IPMT)的诊断价值。方法采用16层螺旋CT对14例IPMT行平扫和动态增强扫描,将动脉期和胰腺期数据传至工作站,重建成厚度为0.75 mm、间距为0.5 mm的高分辨率图像,作曲面重建(curve planar reformation,CPR)和最大密度投影(maximum intensity projection,MIP)。分析主胰管、胰腺实质、十二指肠乳头和胰腺周围血管的CT征象,并将CT的分型和恶变预测的结果与病理对照。结果CT表现为主胰管扩张9例,胰腺实质内囊性病变11例,主胰管和囊性病变内见分隔和(或)结节样突起,十二指肠乳头增大6例,肿瘤侵犯胰腺周围血管1例。CT诊断主胰管型IPMT 3例,分支胰管型IPMT 5例,混合型IPMT 6例,IPMT恶变6例。病理学分型与CT分型一致,镜下诊断导管内乳头状黏液腺癌7例。结论多层螺旋CT重建技术对IPMT的诊断、分型和恶变预测具有重要的临床应用价值。Objective To explore the value of 16-slice computed tomography reformation teeh nology in diagnosing intraductal papillary mucinous tumor （IPMT）. Methods Fourteen cases of IPMT were examined by 16-slice CT including plain scanning and dynamic contrast-enhanced scanning. The arterial and pancreatic enhancement data were transferred to the workstation and reconstructed to the high-resolution image with a slice thickness of 0.75 mm and inter-slice gap of 0.5 mm. Curve planar reformation of the pancreas and maximum intensity projection of the abdominal vessels were then performed. The CT features of pancreatic main duct, the pancreatic parenchyma, the papilla of Vater and the vessels around the pancreas were analyzed. The CT classification and malignant pre diction of IPMT were compared with pathologic results. Results Pancreatic main duct dilation was seen in 9 cases and cystic lesions within the pancreatic parenchyma were seen in 11 cases. Septa and / or nodule were found to be located in the duct and cystic lesions. The orifice widening of the papilla of Vater was seen in 6 cases. The vessel invasion was seen in 1 case. The CT diagnosis was main-duct type IPMT （n=3）, branch-duct type IPMT （n=6） and combined type IPMT （n=5）. Six cases were diagnosed as malignancy. The pathologic classification of IPMT was similar to CT classification and IPMT was diagnosed in 7 cases microscopically. Conclusion Multislice computed tomography reformarion technology is of great value in diagnosing, classifying and predicting malignancy of IPMT.

关 键 词：胰腺肿瘤 计算机断层成像 诊断 

分 类 号：R735.9[医药卫生—肿瘤]