影像学检查对壶腹周围癌诊断价值的临床研究  

Evaluation of imaging examinations in the diagnosis of periampullary carcinoma

作　　者：谢晓燕[1,2] 吕明德[1,2] 杉山政则 跗见裕[1,2] 

机构地区：[1]中山医科大学第一附属医院超声波科 [2]日本杏林大学医学部第一外科

出　　处：《中华普通外科杂志》1999年第2期94-96,共3页Chinese Journal of General Surgery

摘　　要：目的评价各种检查手段对壶腹周围癌的诊断价值，帮助临床医师合理地选择检查方法。方法对胰头及壶腹周围癌患者３４例施行二维超声（Ｂｕｓ）、彩色多普勒超声（ＣＤＩ）、内镜超声（ＥＵＳ）、逆行性胆胰管造影（ＥＲＣＰ）、电子计算机断层扫描（ＣＴ）、核磁共振显像（ＭＲＩ）、血管造影（Ａｎｇｉｏ）及术中超声（ＯＵＳ）检查，比较它们的诊断效能。结果除Ａｎｇｉｏ的诊断符合率不足５０％外，Ｂｕｓ与ＣＤＩ，ＣＴ，ＭＲＩ的诊断符合率相当，约８０％（２７／３４），ＥＵＳ，ＯＵＳ，ＥＲＣＰ的诊断率均达９０％（３２／３４）以上，检出全部直径大于和等于２ｃｍ的癌灶。直径小于２ｃｍ的癌灶１０例，ＥＵＳ及ＯＵＳ均检出８／１０例，ＥＲＣＰ在加用活体组织检查后全部检出，Ｂｕｓ、ＣＤＩ、ＣＴ、ＭＲＩ分别检出３例、３例、２例、４例，Ａｎｇｉｏ则无检出病例。结论ＥＵＳ和ＥＲＣＰ是目前检测微小癌灶最有效的方法，Ｂｕｓ因方便经济可做为首选的检查手段。Objective We evaluate the diagnostic value of imaging examinations for patients with periampullary carcinoma.Methods In this study 34 patients suspected to have sufferred from periampullary carcinoma underwent B mode ultrasonography(B us),color doppler imaging (CDI), endoscopic ultrasonography (EUS), ERCP, CT, MRI , Angiography and operative ultrasonography (OUS).Results The detective rates for tumors more than 2cm in diameter were 100% by all imaging methods except for angiography. The tumor detecting rates of EUS, OUS and ERCP were more than 90%(32/34),while of B us, CDI, CT and MRI were about 80%(27/34). Of 10 cases with tumors less than 2cm in diameter, EUS and OUS detected 8,respectively.ERCP plus biopcy detected all of the 10, B us and CDI detected 3,respectively. CT and MRI found 2 and 4 respectively,while none was detected by angiograpy.Conclusions Our study suggested that EUS and ERCP plus biopsy were the most sensitive methods for detecting small tumor, B us was the first choice for scanning the lesions and CDI was helpful in locating the tumor.

关 键 词：壶腹周围癌 影像学诊断 EUS ERCP 

分 类 号：R735.04[医药卫生—肿瘤]