多层螺旋CT胰腺增强扫描:扫描方案的选择及对胰周血管的评价  

Contrast-enhanced MDCT of pancreas:determination of an optimal scanning technique and its effectiveness in the evaluation of peripancreatic vessels

作　　者：张红梅[1] 周纯武[1] 赵心明[1] 刘媛[1] 马霄红[1] 

机构地区：[1]中国协和医科大学中国医学科学院肿瘤医院影像诊断科,北京100021

出　　处：《医学影像学杂志》2009年第3期294-297,共4页Journal of Medical Imaging

基　　金：国家"十一五"科技支撑计划课题(编号:2007BA105B05)

摘　　要：目的:通过胰腺同层动态增强扫描,获得感兴趣区的时间-密度曲线,确定胰腺增强扫描的最佳延迟时间,并应用此扫描方案分析胰周血管的显示率。方法:①随机选择20例无胰腺疾病的患者进行胰腺同层动态增强扫描,获得感兴趣区的强化峰值及到达峰值时间;②随机选择40例无胰腺疾病的患者进行胰腺三期增强扫描,分析胰周血管的显示率。结果:①腹主动脉强化峰值时间约为30s,平均强化峰值为350.3HU,20s时平均CT值为316.7HU;门静脉强化峰值时间约为45s,胰腺实质强化峰值时间约为40s,肝脏实质强化峰值时间约为55s,曲线到达峰值后75s内处于平台期;②胰周主要动脉(CA、HA、SA、SMA)的显示率为100%(40/40),除AIPDA以外的其它胰周小动脉显示率为75%～100%。胰周主要静脉(PV、SV、SMV)的显示率为100%(40/40),除AIPDV以外的其它胰周小静脉显示率为75%～100%。结论:在注射剂量100ml,注射流率4ml/s时,建议多层螺旋CT胰腺增强扫描的延迟时间分别为动脉期20s,胰腺实质期45s,门静脉期或肝脏期70s。Objective： To determine the optimal delay times for multiphase contrast-enhanced MDCT of pancreas, and to evaluate the display rate of pefipancreatic vessels using this scanning teclmique. Methods： ①20 patients with normal pancreas were selected randomly, and all of them underwent single-level contrast-enhanced MDCr examinations of pancreas. The peak value （HU） and the time to peak value of ROI （including peripancreatic aorta, portal vein, pancreatic and hepatic parenchyma ） were obtained; ②40 patients with normal pancreas were selected at random for 3-phasic contrast-enhanced MDCr of pancreas, and the display rates of peripancreatic vessels were analyzed. Results： ①The average time to peak value of the peripancreatic aorta, portal vein, pancreatic and hepatic parenchyma were about 30 s, 45 s, 40 s, and 55 s, respectively. The average CT value of peripancreatic aorta was 316 HU at 20 s, the platform stage for hepatic parenchyma ranged from 55 to 75 s; ② The display rate of main peripanceatic arteries was 100%, the display rate of the other peripancreatic arteries except AIPDA was 75% - 100%. The display rate of main peripanceatic veins was 100%, the display rate of the other peripancreatic veins except AIPDV was also 75% - 100%. Conclusion：With the contrast dosage of 100 ml and the injection rate of 4 ml/s, the optimal delay times for 3-phasic contrast-entranced MDCT of pancreas are suggested as follows： 20 s for arterial phase, 45 s for pancreatic parenchyma phase, and 70 s for hepatic plase.

关 键 词：胰腺 胰周血管 体层摄影术 X线计算机 

分 类 号：R657.5[医药卫生—外科学] R814.42[医药卫生—临床医学]