胰腺癌胰实质期增强MSCT表现与病理的对照研究  

Pancreatic Carcinoma:MSCT Assessment with Pathologic Correlation During Pancreatic Parenchymal Phase

作　　者：史讯[1] 曾蒙苏[1] 张志勇[1] 靳大勇[2] 楼文晖[2] 纪元[3] 

机构地区：[1]复旦大学附属中山医院放射科 [2]复旦大学附属中山医院胰腺外科 [3]复旦大学附属中山医院病理科

出　　处：《放射学实践》2008年第8期897-900,共4页Radiologic Practice

摘　　要：目的:探讨胰腺癌胰实质期增强MSCT表现的病理学基础,提高胰腺癌诊断和鉴别诊断的准确性。方法:搜集手术病理证实为胰腺癌患者共23例,术前均行CT平扫和胰腺实质期、肝脏实质期两期增强扫描,观察病灶平扫和增强表现,并根据其强化方式的不同分为A^F六种类型,将各型MSCT表现与病理结果进行对照分析。结果:23例肿瘤中,17例平扫呈低密度,4例为略低密度,2例为等密度。在胰腺实质期中,17例平扫呈低密度的病灶增强后出现B、C、D、E、F型强化方式分别有1、1、12、2和1例;4例平扫呈略低密度病灶中出现B、C、E、F型强化方式各1例;2例平扫等密度病灶增强后,1例表现为A型,另1例为C型强化方式。23例中胰腺导管内乳头状黏液腺癌(IPMC)有2例,强化方式均表现为D型。结论:胰腺癌各型MSCT表现与肿瘤的病理分级、其内部各组织成分构成比密切相关。IPMC有着与传统的导管腺癌不同的影像学表现。Objective： To study the pathologic essence of MSCT findings of pancreatic carcinoma during pancreatic parenchymal phase and to improve the accuracy of diagnosis. Methods：Twenty three patients, proved to be pancreatic carcino ma,underwent CT scanning before resection. The unenhancement and enhancement forms of tumor were observed. According to the enhancement of tumor,the forms were divided into six types：A-F CT enhancement of the tumor and pathological findings of pancreatic carcinoma were comparatively analyzed. Results：Low density were observed in 17 cases during unenhancement phase, slight low density in 4 cases and isodensity in 2 cases. During pancreatic phase, 1,1,12,2,1 cases were found with B,C, D, E, F type among the 17 cases mentioned with low density, respectively. Four cases with slight low density was observed in B,C,D,E type,respectively. Between the 2 cases with isodensity,one is type A,and the other is type C. Among the 23 cases,two IPMC was demonstrated D type during pancreatic phase. Conclusion：The enhanced degree of pancreatic carcinoma depends on pathological grade and different component of tissue in tumor. IPMC is a special type pancreatic adenocarcinoma with the characteristical imaging feature.

关 键 词：胰腺 肿瘤 组织学 体层摄影术 X线计算机 

分 类 号：R735.9[医药卫生—肿瘤]