不典型胰腺癌的18例CT诊断  

18 cases of atypical CT diagnosis of pancreatic cancer

作　　者：杨璧 杨赤[2] 

机构地区：[1]广东省信宜市中医院CT室,广东信宜525300 [2]广东省信宜市人民医院急诊科,广东信宜525300

出　　处：《世界最新医学信息文摘》2013年第14期18-18,15,共2页World Latest Medicine Information Electronic Version

摘　　要：摘要：目的探讨不典型胰腺癌的CT诊断。方法回顾性分析2011年1月至2012年1月间信宜市中医院及信宜市人民医院收治的18例不典型胰腺癌患者的临床资料及CT检查结果。结果18例患者中，胰腺癌发生于胰头部8例，胰体部3例，胰尾部2例，误诊为正常胰腺2例，胰腺炎3例。误诊率为27．8％。18例胰腺癌患者CT表现均不典型。7例胰头部表现为等、低密度或囊实性肿块，增强后无明显强化。4例胰头部大小不一的囊性病灶，增强后仅囊性病灶下方部分实性部分轻度强化。4例胰体部胰管中度扩张，胆总管、肝内胆管及邻近血管未受侵犯。3例胰体部及胰尾部胰管轻度扩张，但胆总管和肝内胆管均未见扩张。3例平扫可见胰腺内局灶性CT值增高。增强扫描时该区域不强化。2例患者平扫示胰腺密度不均匀，增强扫描时无明显强化。18例胰腺癌患者中，中分化导管腺癌8例，黏液腺癌5例，腺鳞癌5例。结论胰腺癌可出现不典型的CT影像表现，要注意结合临床表现及其他检查与易混淆疾病进行鉴别诊断。Objective to study the atypical CT diagnosis of pancreatic cancer. Methods a retrospective analysis in January 2011-2012 of our hospital between January 18 cases of patients with atypical pancreatic cancer clinical data and CT examination results. Results 18 cases of pancreatic cancer occurs in the pancreatic head, 8 cases of pancreatic body 3 cases, pancreatic tail in 2 cases, 2 cases were misdiagnosed as normal pancreas, pancreatitis （3 cases）. The misdiagnosis rate was 27.8%. 18 patients with pancreatic cancer CT manifestations are not typical. 7 cases of pancreatic head of solid tumors, such as low density or sac, no obvious enhancement. 4 cases of cystic pancreatic head sizes, enhanced solid cystic focal part below component only mild reinforcement. 4 cases of pancreatic body moderate expansion of the pancreatic duct, common bile duct, intrahepatic bile ducts and nearby blood vessels are not infringed. 3 cases of pancreatic body and tail of pancreas, pancreatic duct mild expansion, but the common bile duct and dilatation of the intrahepatic bile ducts are not seen. 3 cases of scan shows intrapancreatic focal increased CT value, enhanced scan the area is not improved. Scan in 2 cases with pancreas uneven density, enhancement scan, no obvious reinforcement. Differentiation catheter in 18 cases of patients with pancreatic cancer, 8 cases of adenocarcinoma and mucous adenocarcinoma in 5 cases, glands squamous carcinoma in 5 cases. Conclusion the CT imaging manifestation of pancreatic cancer can appear not typical, pay attention to the combination of clinical manifestations and other examination and confusing disease in the differential diagnosis.

关 键 词：不典型 胰腺癌 CT 

分 类 号：R445[医药卫生—影像医学与核医学]