MSCT最小密度投影联合曲面重建胰胆管成像对壶腹部周围癌的诊断价值  

Diagnostic value of MinIP combined with CPR technique of MSCT in periampullary carcinoma

作　　者：梁萍[1] 方华盛[1] 陈更瑞[1] 邓琳[1] 

机构地区：[1]北海市人民医院放射科,广西北海536000

出　　处：《实用放射学杂志》2013年第1期45-48,共4页Journal of Practical Radiology

基　　金：广西壮族自治区卫生厅自筹经费科研课题（Z2010004）.

摘　　要：目的探讨多排螺旋CT（MSCT）的最小密度投影（MinIP）联合曲面重建（CPR）胰胆管成像在壶腹部周围癌诊断中的心用价值。方法 收集34例壶腹部周围癌致梗阻性黄疸患者，进行胆管或胰管的MinIP＋CPR重建，对壶腹部周围结构和胰胆管壁的显示效泉及诊断能力进行评价。结果 胆总管末端癌10例，重建图像显示管壁不规则增厚，管腔狭窄梗阻或被软组织肿块完全充填，肝内外胆管扩张较不，胰管扩张较轻；Vater壶腹癌10例，显示壶腹圆形等密度结节，胆胰管全程扩张呈“双符征”；十二指肠癌8例，显示十二指肠内不规则软组织肿块，梗阻端以上的十二指肠及胆管均扩张，6例伴胰管轻度扩张；胰头癌6例，肿块远端胰管明显扩张，胆总管呈“截断状”或受压弧形狭窄，均有胰体尾部实质的萎缩。MinIP＋CPR的定位、定性诊断准确半均达94．1％。结论MSCT的MinIP＋CPR胰胆管成像是壶腹部周围癌的有效检查方法。Objective To evaluate the efficiency of MinlP combined with CPR technique of MSCT in diagnosis of periampullary cancer. Methods MinIP combined with CPR technique of MSCT was performed in 34 patients with obstructive jaundice caused by Periampullary carcinoma,The diagnostic value and image quality were analysed for biliary duct structure , biliary duct wall or pan- creatic duct wall. Results 10 cases with terminal bile duct cancer showed irregular wall thickening, stenosis and obstruction or soft tissue mass completely filling, extrahepatic bile duct dilatation heavier, pancreatic duct dilatation lighter on the reconstructed image; while 10 cases with carcinoma of the ampulla of Vater showed round iso density nodules at ampulla of Vater with＂double duct sign＂. Eight cases with carcinoma of the duodenum showed irregular soft tissue mass in the duodenum, the proximal duodenum and the bile duct above the obstruction expansion, while six patients with pancreatic duct mild expansion. Six cases with pancreatic cancer showed a remarkable expansion of tumor distal pancreatic duct with the atrophy of both the pancreatic body and tail. The diagnostic accuracy rate for MinlP combined with CPR in locating and defining the lesion was 94.1% Conclusion MinIP combined with CPR technique of MSCT is reliable for diagnosis of periampullary carcinoma.

关 键 词：计算机体层成像 图像后处理 胰胆管成像 壶腹部周围癌 

分 类 号：R814.42[医药卫生—影像医学与核医学] R735[医药卫生—放射医学]