双期薄层动态增强CT在胰岛素瘤术前诊断中的价值  

Value of Dual-phase Thin Thickness Dynamic Enhanced Muti-row Detector CT in the Preoperative Diagnosis of Pancreatic Insulinoma

作　　者：刘玉[1] 宋琦[1] 金涵弢 方文强[1] Manavendra Upadhyaya 陈克敏[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院放射科,上海200025

出　　处：《放射学实践》2009年第3期274-278,共5页Radiologic Practice

基　　金：上海市科学技术委员会科研计划项目(08411966500)

摘　　要：目的:定量分析胰岛素瘤动态增强扫描各期相的强化特点,探讨胰岛素瘤术前CT诊断的价值。方法:回顾性分析38例经手术及病理证实的胰岛素瘤患者的影像学资料,对肿瘤的形态特点、各期相的强化方式和强化程度及CT定位诊断的敏感度及假阴性的潜在原因等进行分析。结果:胰岛素瘤术前薄层双期增强CT诊断的敏感度为81.6%,单纯动脉期CT诊断的敏感度为81.6%,门静脉期为60.5%,两者间的差异有统计学意义(P=0.043)。胰岛素瘤平扫时平均CT值(40.32±8.13)HU,周围正常胰腺组织平均CT值为(44.48±6.75)HU,两者差异有极显著性意义(P<0.001)。38例中有36例肿瘤至少在一个期相上强化明显。动脉期胰岛素瘤的平均CT值(113.66±27.26)HU,周围正常胰腺组织为(80.5±15.43)HU;门静脉期胰岛素瘤的平均CT值为(111.59±19.05)HU,周围正常胰腺组织为(90.5±13.91)HU,两者间差异均有统计学意义(P<0.001)。胰岛素瘤动脉期强化值(73.44±29.23)HU,门静脉期为(71.22±21.64)HU,两者间差异没有统计学意义(P=0.627);胰岛素瘤动脉期较周围正常胰腺组织的强化程度为(33.16±20.64)HU,门静脉期为(20.09±16.31)HU,两者间差异有统计学意义(P=0.006)。7例漏诊的病例中,5例呈等密度,2例为异位胰岛素瘤。结论:薄层双期CT增强扫描对检查胰岛素瘤有较高的敏感性,动脉期扫描的诊断价值大。Objective：To quantitatively analyze the enhancement characteristics of pancreatic insulinoma in different phases and to study the value of muhi-row detector CT （MDCT） in the diagnosis before surgery. Methods：The CT materials of 38 patients with surgery and pathology proven insulinoma were reviewed. The morphology,enhanced pattern in vari ous phases,degree of enhancement as well as the sensitivity for tumor localization and potential causes of false negative diagnosis were retrospectively analyzed. Results： The sensitivity for the preoperative diagnosis of insulinoma was 81. 6% with dynamic enhanced dual phase MDCT. The sensitivity was 81.6% in the arterial phase and 60.5% in the portal venous phase with significant statistical difference （P =0. 043）. The mean attenuation values of the insulinoma and the surrounding tumor-free normal pancreatic parenchyma on the unenhanced images were （40.32±8. 13）HU and （44.48± 6.75）HU re spectively,with significant statistical difference （P〈0. 001）. Of the 36 tumors,obvious enhancement could be showed on at least one phase after contrast administration. The mean CT attenuation values of the insulinoma and the surrounding normal pancreatic parenchyma on arterial phase was （113. 66 ± 27. 26）HU and （80. 5 ± 15. 43）HU respectively, with significant statistical difference （P〈0. 001）. The mean attenuation values of the insulinoma and the normal pancreatic parenchyma on the portal phase was （111.59± 19.05）HU and （90.5 ± 13.91 ）HU respectively, with significant statistical difference as well （P〈0. 001）. The attenuation of insulinoma in the arterial phase and the portal venous phase was （73.44±29.23）HU and （71.22 ± 21.64）HU respectively, with no significant statistical difference （P=0. 627）. The tumor to normal pancreas atten uation difference in the arterial phase and portal venous was （33. 16±20. 64）HU and （20.09 ± 16. 31 ）HU respectively, with significant statistical difference （P= 0. 006）. In th

关 键 词：胰腺肿瘤 体层摄影术 X线计算机 动态增强扫描 

分 类 号：R736.7[医药卫生—肿瘤]