螺旋CT双期扫描对胰腺癌可切除性的评价  

Assessment of Resectability of Pancreatic Cancer with Dual-Phase Spiral CT

作　　者：严志汉[1] 周翔平[1] 宋彬[1] 刘荣波[1] 许崇永[1] 黄娟[1] 李昌宪[1] 侯彩芳[1] 

机构地区：[1]华西医科大学附属第一医院放射科,成都610041

出　　处：《临床放射学杂志》2000年第6期355-358,共4页Journal of Clinical Radiology

摘　　要：目的　评价螺旋CT双期扫描对胰腺癌可切除性的价值。材料与方法　对 42例拟诊胰腺癌随后又行手术治疗的患者作出前瞻性的诊断和可切除性的评估。病理结果 :胰腺癌 3 3例 ,非胰腺癌 9例。CT双期延迟扫描时间分别为 2 5s和 60s。并将CT判断的结果与手术结果作对比。结果　 42例中 ,螺旋CT正确诊断 3 9例 ( 93 % )。螺旋CT判断可切除性的敏感性为 89% ,特异性为92 % ,准确性为 91%。 10例肝转移癌 ,CT诊断 8例 ( 80 % ) ;9例腹膜癌变 ,CT诊断 5例 ( 5 6% ) ;关于胰周血管是否受侵 ,2 1例中CT判断正确 19例 ( 91% )。结论　螺旋CT不仅诊断胰腺癌的准确性高 ,而且判断其可切除性的准确性也高 ,因而是诊断和术前评估胰腺癌最全面而准确的影像学手段之一。螺旋CT双期薄层扫描判断胰周血管是否受侵的准确性较高 ,从而提高了可切除性判断的准确性 。Objective To evaluate dual phase spiral CT scanning in assessing the resectability of pancreatic cancer.Materials and Methods The resectability and diagnosis were prospectively evaluated in 42 patients with suspicious pancreatic cancer who underwent surgery later. Pathologic results confirmed pancreatic cancer in 33 cases and not confirmed pancreatic cancer in 9 cases. Dual phase CT scans were obtained with the delayed time of 25 or 60 seconds, respectively. A comparison of CT diagnosis with surgical findings was made.Results Of total 42 cases, 39 (93%) were correctly diagnosed on spiral CT. For prediction of resectability, spiral CT carries an accuracy of 91%, sensitivity of 89% and specificity of 92%. CT detected liver metastases in 8 of 10 cases (80%) and peritoneal carcinomatosis in 5 of 9 cases (56%), and correct judgement as whether the peripancreatic vessels were invaded was obtained in 19 of 21 cases (91%).Conclusion (1) Spiral CT scanning exhibits high accuracy both in diagnosing pancreatic cancer and in assessing the peripancreatic vascular invasion, therefore, it is the most valuable and precise imaging technique for preoperative assessment of pancreatic cancer. (2) Dual phase thin slice spiral CT scanning can accurately assess the peripancreatic vessels, though it has limited value in detecting small liver metastases and peritoneal carcinomatosis.

关 键 词：螺旋CT 胰腺癌 可切除性 评价 

分 类 号：R735.9[医药卫生—肿瘤]