胰头部肿块型慢性胰腺炎与胰头癌的CT鉴别诊断  

Differential diagnostic value of CT in the mass-type chronic pancreatitis in the head of the pancreas and carcinoma of head of pancreas

作　　者：田笑[1] 鹿强[1] 殷小平[1] 梁广路[1] 

机构地区：[1]河北大学附属医院CT/MRI科,河北保定071000

出　　处：《中国临床医学影像杂志》2010年第8期549-552,共4页Journal of China Clinic Medical Imaging

摘　　要：目的：分析胰头部肿块型慢性胰腺炎和胰头癌的CT表现及鉴别要点,以提高其CT诊断和鉴别诊断能力。资料与方法：回顾性分析2003年4月~2009年7月我院证实的30例胰头部肿块型慢性胰腺炎与30例胰头癌患者的CT资料,总结其CT特征。结果：胰头部肿块型慢性胰腺炎与胰头癌主要CT鉴别点：①肿块钙化（17例,0例）;②门脉期肿块强化与正常胰腺对比,呈相对低密度（2例,30例）,相对等密度（28例,0例）;③胰体尾萎缩（0例,18例）,胰腺假囊肿（13例,1例）;④胰管扩张（18例,25例）,胰管钙化（13例,0例）,病灶处胰管截断（4例,12例）,病灶处胰管贯通（14例,1例）;⑤胆管扩张（25例,12例）,病灶处胆管截断（2例,21例）,病灶处胆管逐渐变细（10例,4例）;⑥不相交征（0例,20例）。结论：胰头部慢性肿块型胰腺炎与胰头癌的CT表现具备一定特征性,CT检查能够为两者的鉴别提供重要依据。Objective：To analyze CT characteristics of pancreatic carcinoma and chronic pancteatitis with mass in the head of the pancreas in order to improve its CT differential diagnostic accuracy.Materials and Methods：The clinical data of 30 cases with mass-type chronic pancreatitis in the head of the pancreas and carcinoma of head of pancreas were retrospec-tively analyzed.Results：The main CT differential points of the mass-type chronic pancreatitis and carcinoma of head of pan-creas could be summarized as follows：①calcification within the mass（17 cases,0 case）;②contrast：lesions were raltive low density in portal venous phase（2 cases,30 cases）,and raltive equal density（28 cases,0 case）;③shrink of the tail of pancreas（0 case,18 cases）,pancreatic pseudocyst（13 cases,1 case）;④dilatation of the pancreatic duct（18 cases,25 cases）,string of beads of dilation of pancreatic duct（15 cases,4 cases）,smooth dilation（3 cases,21 cases）,dilated pancreatic duct interrupt in the lesion area（4 cases,12 cases）,dilated pancreatic duct passed through the lesion area（14 cases,1 case）;⑤dilatation of bile duct（25 cases,12 cases）,interrupt in the lesion area（2 cases,21 cases）,tapering from above downward（10 cases,4 cases）;⑥ no cross sign（0 case,20 cases）.Conclusion：The CT findings of the pancreatic head mass in chronic pancreatitis is charac-teristic,CT plays an important role in the of diagnosis and differential diagnosis of the two diseases.

关 键 词：胰腺炎 胰腺肿瘤 体层摄影术 螺旋计算机 

分 类 号：R576[医药卫生—消化系统] R735.9[医药卫生—内科学]