乳头型壶腹癌螺旋CT双期增强的表现  

Enhanced dual-phase spiral CT features of polypoid ampullary carcinoma

作　　者：曾蒙苏[1] 严福华[1] 周康荣[1] 陈惠明[1] 陈刚[1] 陈锦[1] 

机构地区：[1]复旦大学医学院附属中山医院放射科,上海200032

出　　处：《中华放射学杂志》2001年第4期267-269,共3页Chinese Journal of Radiology

摘　　要：目的　了解螺旋CT双期增强扫描显示乳头型壶腹癌的CT表现。方法　回顾性分析15例经手术病理证实的乳头型壶腹癌的CT表现 ,螺旋CT采用薄层双期 (动脉和门脉 )增强扫描 ,动脉期扫描采用层厚 5mm ,螺距 1 0 ;门脉期扫描层厚和间隔均为 5mm。结果　螺旋CT动脉和门脉期增强扫描 ,15例均清晰显示十二指肠乳头部局限性强化的充盈缺损块影 ,肿瘤瘤径为 1～ 5cm ,平均2 3cm。所有病例均可见肝内胆管扩张、胆囊增大、胆总管扩张和胰腺管的扩张 ,仅有 1例伴胰体尾部的明显萎缩。结论　螺旋CT双期增强扫描不仅能准确确定梗阻的平面 ,还能显示十二指肠乳头部壶腹癌强化的肿块影 ,这对诊断乳头型壶腹癌是关键的CT征像。Objective To understand CT features of polypoid ampullary carcinoma by enhanced dual-phase spiral CT.Methods 15 cases of polypoid ampullary carcinoma (PAC) confirmed by surgical and pathological results were studied with thin slice enhanced dual-phase spiral CT (including arterial and portal phase scanning)with retrospective analysis, the scanning parameters were 5 mm thickness and 1.0 pitch for arterial phase scanning , and 5 mm thickness and 5 mm space for portal phase scanning. Results All cases could display an enhanced mass as local filling defect at the site of the duodenal Vater′s ampulla during arterial and portal phase scanning, the tumors ranged in size from 1 cm to 5 cm with mean of 2.3 cm, all were accompanied with dilated intrahepatic and common bile duct, enlarged gallbladder and dilated pancreatic duct, except one case which had marked atrophy of the pancreatic body and tail. Conclusion The thin slices enhanced dual-phase spiral CT could not only accurately define the level of obstruction,but also demonstrate an enhanced mass as direct CT sign of the PAC, which is crucial for diagnosis of the PAC.

关 键 词：乳头型壶腹癌 螺旋CT 诊断 

分 类 号：R735.0[医药卫生—肿瘤]