胰腺钩突角角度变化在CT诊断胰头占位中的意义  

Uncinate Process Angles in the Diagnosis of Space-occupying Lesions of the Head of Pancreas.

作　　者：梅志军[1] 刘瑞[1] 唐岩[1] 邵成伟[2] 江浩[3] 

机构地区：[1]第二军医大学附属长海医院普通外科,200433 [2]第二军医大学附属长海医院放射科,200433 [3]上海第二医科大学瑞全医院放射科

出　　处：《外科理论与实践》2001年第2期73-75,共3页Journal of Surgery Concepts & Practice

摘　　要：探讨胰腺钩突角角度变化在ＣＴ诊断胰头占位中的意义。方法：定义ＣＴ片上胰腺钩突前后两边之夹角为胰腺钩突角。测量４９０例患者ＣＴ片上胰腺钩突角大小。分３组：Ａ组（ＣＴ诊断假阴性组）为２０例术前ＣＴ未能发现胰头占位但经手术及病理证实有胰头占位性病变的患者；Ｂ组（胰头占位组）为５０例ＣＴ及病理均诊断胰头癌的患者；Ｃ组（对照组）为４２０例非胰腺疾病患者。结果：自十二指肠水平部以上和胰头最下层向上测量称为Ⅰ－Ⅵ个层面。对照组各层面胰腺钩突角的大小从下向上依次为３０°±９°、３４°±１０°、３７°±１０°、３７°±１２°、３７°±１４°和２５°±１３°。计算Ａ、Ｂ、Ｃ３组各病例各层面中最大角度之平均值分别为９０°±７、９６°±１６°、４７°±９°，与Ｃ组相比，Ａ、Ｂ两组均明显增大（Ａ组与Ｃ组比较，ｔ＝３１.4２，Ｐ＜０．００１；Ｂ组与Ｃ组比较，ｔ＝３６．５３，Ｐ＜０．００１）。结论：胰腺钩突角增大是诊断胰头占位的有意义指标。凡是钩突角增大（＞７５°）的病例均应高度怀疑胰头占位，有待进一步检查。To explore the relationship between the uncinate process angles in CT scanning and the space-occupying lesions of the head of pancreas. Methods: The term uncinate angle is defined as the angle made up of the anterior side and the posterior side of the uncinate process. The uncinate angle was measured in 490 CT pictures which were divided into three groups: Group A, 20 surgically and histopathologically proven cases of space-occupying lesions in the head of pancreas, not diagnosed by CT prior to surgery; Group B, 50 cases of adenocarcinoma in the head of pancreas diagnosed both by CT and histopathology; Group C, 420 cases without presence of any pancreatic lesion. Results: In group C, the mean size of the uncinate angle in 4 levels marked from the lower border upward is 30°±9°、34°±10°、37°±10°、37°±12°、38°±14° and 25°±13°respectively. The angle in cases belonging to group A and group B is significantly wider than that of group C cases(A vs C: 90°±7°vs 47°±9°, t= 31.42, P<0.01; B vs C: 96°±16°vs 47°±9°, t= 36.53, P<0.001). Conclusions: The widening of the un- cinate process angle in CT scanning is a sensitive sign suggesting space-occupying lesions in the head of pancreas.

关 键 词：胰腺 钩突角 断层摄影术 计算机体层摄影术 胰头占位 CT 

分 类 号：R735.9[医药卫生—肿瘤] R730.44[医药卫生—临床医学]