MSCTE联合MRCP对十二指肠乳头癌和十二指肠乳头腺瘤的诊断价值  

Diagnostic value of MSCTE combined with MRCP in duodenal papillary carcinoma and duodenal papillary adenoma

作　　者：王佳[1] 李辉[1] 牛俊巧[1] 李晓娟 Wang Jia;Li Hui;Niu Junqiao;Li Xiaojuan(Radiology Center,People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院放射影像中心,新疆乌鲁木齐830001

出　　处：《实用肿瘤杂志》2020年第5期464-468,共5页Journal of Practical Oncology

摘　　要：目的探讨多层螺旋CT小肠造影(multi-slice CT enterography,MSCTE)联合磁共振胰胆管造影术(magnetic resonance cholangio pancreatography,MRCP)对十二指肠乳头癌和十二指肠乳头腺瘤的诊断价值。方法回顾性分析经手术病理证实的65例十二指肠乳头癌及10例十二指肠乳头腺瘤的影像特征,并进行对照分析。结果十二指肠乳头癌组和腺瘤组胰和胆管直径和胆囊横径比较,差异均具有统计学意义(均P<0.01)。十二指肠乳头癌门脉期强化值与肿瘤长径具有高度相关性(r=0.60,P<0.01)。MRCP对显示胰胆管扩张更直观,对筛查轻度的胰管扩张较CT和超声检查更准确。十二指肠乳头癌组3例由腺瘤恶变而来,10例乳头腺瘤组中9例有不典型增生。结论MSCTE联合MRCP对十二指肠乳头癌和腺瘤的鉴别具有很高的价值,十二指肠乳头腺瘤有发展成为腺癌的危险,需要密切随访和监测。Objective To explore the diagnostic value of multi-slice spiral CT enterography(MSCTE)combined with magnetic resonance cholangiopancreatography(MRCP)in duodenal papillary carcinoma and duodenal papillary adenoma.Methods The imaging features of 65 cases of duodenal papillary carcinoma and 10 cases of duodenal papillary adenoma confirmed by operation and pathology were analyzed retrospectively.Results The diameter of pancreatic duct and bile duct and the diameter of gallbladder were significantly different between the duodenal papillary carcinoma group and duodenal papillary adenoma group(both P<0.01).There was a high correlation between the portal phase enhancement value and the tumor length and diameter in duodenal papillary carcinoma(r=0.60,P<0.01).MRCP was more direct to show the dilatation of pancreaticobiliary duct,and more accurate to screen mild dilatation of pancreatic duct than CT and ultrasonography.In the duodenal papillary carcinoma group,3 cases were developed from adenoma and 9 cases were atypical hyperplasia in the duodenal papillary adenoma group.Conclusion MSCTE combined with MRCP has high application value for the identification of duodenal papillary carcinoma and duodenal papillary adenoma.Duodenal papillary adenoma may become malignant,which requires close follow-up and monitoring.

关 键 词：十二指肠肿瘤/影像诊断 癌 乳头状/影像诊断 腺瘤/影像诊断 胰胆管造影术 内窥镜逆行 体层摄影术 螺旋计算机 小肠/影像诊断 造影剂 诊断 鉴别 回顾性研究 

分 类 号：R735.31[医药卫生—肿瘤]