乏特氏壶腹癌的多层螺旋CT诊断  

MSCT evaluation of ampulla Vater carcinoma

作　　者：许辉 蔡赞欢 

机构地区：[1]上海市青浦医院放射科,201700

出　　处：《上海医学影像》2011年第1期24-26,共3页Shanghai Medical Imaging

摘　　要：目的探讨乏特氏（Vater）壶腹癌的多层螺旋CT诊断。方法回顾性分析56例经手术病理证实的乏特氏壶腹癌的螺旋CT表现,每例患者CT扫描前均口服800~1 000 mL纯净水充盈胃及十二肠,采用常规平扫＋增强扫描。结果 56例患者CT图像能明确壶腹部肿块,显示率为100%,术前诊断壶腹部癌47例,胆总管癌（下段）6例,胰头癌3例,术前诊断准确率为85%,CT双期动态增强较平扫进一步显示病变部位、大小、与周围组织关系、侵犯范围、血供情况、周围淋巴结及远处转移等表现。30例采用了后处理技术。结论多排螺旋CT增强扫描,结合后处理技术的使用,更加直观显示壶腹癌直接征象、间接征象,使鉴别诊断成为可能,为临床治疗提供重要帮助。Objective To explore the value of multidetector CT in diagnosis of Vater＇s ampullary carcinoma.Methods In this retrospective study based on fifty-six cases with ampullary carcinoma confirmed by post-operation pathology,features of multidetector CT were analyzed.All patients drank 800~1000 ml purified water to fill the guts before scanning,and were accepted both regular scan and enhanced scan.Results Lesions in Vater＇s ampullary could be detected clearly in all patients by CT images.Diagnosis based on CT images before surgery,including 47 cases of Vater＇s ampullary carcinoma,6 cases of carcinoma of low obstructions in billiary tract,and 3 cases of pancreatic head carcinoma,indicated the eighty-five per cent accuracy compared with pathology.Double stages enhanced scan in CT had the stronger abilities to display the site,size,adjacent,invasive fields,blood supply,surround lymph nodes,and metastases than regular scan.Besides,30 cases were used post-treat techniques.Conclusions Multidetector CT combined with post-treat techniques can display the direct or indirect signs of Vater＇s ampullary carcinoma more clear,which makes differential diagnosis possible and helps for therapy.

关 键 词：乏特氏壶腹癌 体层摄影术 X线计算机 诊断 

分 类 号：R734.2[医药卫生—肿瘤]