胰头癌胰周良恶性淋巴结的双源 CT 对比研究  

Compartive study of dual-source computed tomography for the benign or malignant lymph node of pancreatic head cancer

作　　者：莫显斌[1] 杜明珊[2] 杨春[1] 蔡萍[2] 姚倩东[1] 侯文静[2] 陈康[2] 

机构地区：[1]四川省科学城医院放射科,四川绵阳621900 [2]第三军医大学西南医院放射科

出　　处：《实用放射学杂志》2014年第12期2010-2012,2019,共4页Journal of Practical Radiology

摘　　要：目的：探讨双源 CT 对胰头癌胰周良恶性淋巴结的鉴别价值。方法分析手术病理证实的119例胰头癌患者的双源 CT平扫及增强资料,记录淋巴结的部位、数目,测量其短、长径并计算短长径比,比较其强化方式及 CT 值变化。计量资料组间均数比较采用 t 检验,计数资料采用χ2检验。结果119例胰头癌患者胰周淋巴结转移率为68.1%（81/119）。切除标本中共检出334枚淋巴结,其中239枚为转移,占71.6%,反应性增生95枚,占28.4%。增强后淋巴结环状强化、均匀强化的转移率分别为99.1%（111/112）、57.7%（128/222）,转移淋巴结、反应性增生淋巴结 CT 值增加分别为（23.8±3.2）HU、（14.3±2.3）HU,以及良恶性淋巴结的平均短径、长径、短长径比,组间比较,差异均有统计学意义（P 〈0.05）。结论双源 CT 能清晰显示胰头癌胰周淋巴结,当淋巴结短径≥8 mm、长径≥12 mm、短长径比≥0.75时,增强后淋巴结环状强化、强化前后 CT 值增加≥25 HU 时,强烈提示淋巴结转移。Objective To investigate differential diagnostic value of dual-source computed tomography （DSCT）for the benign or malignant lymph node of pancreatic head cancer.Methods The plain and contrast DSCT data of 1 1 9 patients with pancreatic head cancer proved by operation and pathology were analyzed retrospectively.The distributions,number,short and long axis diameters and ratio of short-to long-axis diameter,enhancement modality and enhancement degree of lymph nodes were recorded.A1l data were analyzed using the t test or chi-square test.Results The positive rate of lymph node metastasis was 68.1% （81/1 1 9）.Lymph node metastases were found in 239 out of 334 lymph nodes,and reactive hyperplasia were found in 95 lymph nodes （28.4%,95/334）.The positive rate of lymphatic metastasis with rim-1ike enhancement was 99.1% （1 1 1/1 12）,which was significantly higher than 57.7% （128/222）of lymphatic metastasis with homogeneous enhancement.The increased CT value of metastatic lymph nodes was （23.8±3.2）HU,which was significantly higher than （14.3±2.3）HU of patients with reactive hyperplasia lymph nodes.The short-and long-axis diameters and the ratio of short-to long-axis diameter showed significant difference between benign or malignant lymph nodes （P 〈0.05 ）.Conclusion DSCT could detect lymph node metastasis of the cancer of the pancreatic head.When the short axis diameter of the lymph nodes ≥8 mm,long axis diameter of the lymph nodes ≥12 mm,the ratio of short-to long-axis di-ameter ≥0.75,and the rim-1ike enhancement and increased value after enhancement ≥25 HU,high sensitivity of dual-source CT for the diagnosis of lymph node metastasis of cancer of the head of pancreas could be achieved.

关 键 词：胰头癌 淋巴结 计算机体层成像 

分 类 号：R735.9[医药卫生—肿瘤] R814.42[医药卫生—临床医学]