摘要
目的：评价多层螺旋CT在胰头癌和壶腹癌诊断中的作用。方法：回顾性分析39例经手术病理确诊的胰头癌和壶腹癌患者的多层螺旋CT表现，其中胰头癌29例，壶腹癌10例，男24例，女15例，年龄39~81岁。应用Siemens Sensation 4层和16层CT，进行增强前后多期扫描。在原始横断面图像基础上结合多层面重建及其它后处理，对两组疾病的多层螺旋CT表现进行总结、比较，统计CT术前诊断的准确性。结果：本组病例的CT主要表现：①壶腹癌瘤体小，易向十二指肠腔突出，中心位于十二指肠腔内；胰头癌的中心则通常在胰腺内。②肿瘤与胆胰管、胰周血管的关系均可清晰显示。③两管靠近（扩张的胆胰管末端间距≤5mm）多见于壶腹癌，而两管分离（扩张的胆胰管末端间距＞5mm）多见于胰头癌。胰头癌和壶腹癌的多层螺旋CT肿块显示率分别为96.6%和90%，术前诊断准确率分别为93.1%和90%。结论：多层螺旋CT可以展现胰头癌和壶腹癌的影像特征，对术前诊断和分期有较高的价值。
Abstract
To investigate the imaging characteristics and diagnostic value of carcinomas of pancreatic head and ampulla with multi-slice CT. Methods: Thirty-nine patients confirmed by surgery and pathology were retrospectively studied, including 29 cases with carcinoma of the head of the pancreas and 10 with ampullary carcinoma, male patients 24, female 15, age ranged from 39~81 years; mean age 65 years. They all underwent the pre- and post-enhanced multi-phase CT examination before operation with Siemens Sensation 4 or 16 multi-slice scanner. On the base of transverse images and with multi-plannar reconstruction and other post-processing techniques, the imaging characteristics of the two groups were analyzed retrospectively and compared. Pre-operative diagnostic accuracy was evaluated statistically. Results: Main CT appearances of this group of cases: ①Ampullary carcinoma manifested as a small mass and was prone to protruding into duodenum, whereas the center of pancreatic head carcinoma was located in pancreas. ②Relationship between tumors and choledochopancreatic ducts and peripancreatic vessels were showed clearly. ③Getting together of the two ducts(distance between distal ends of the dilated common bile duct and the dilated main pancreatic duct≤5mm) was usually seen in ampullary carcinomas, while separation of the two ducts(distance between distal ends of the two dilated ducts＞5mm) was mostly seen in carcinomas of pancreatic head. In our patients, 96.9% tumors of pancreatic head and 90% ampullary masses were displayed before operation by multi-slice CT. The pre-operative diagnostic accuracy for carcinomas of pancreatic head and ampulla with multi-slice CT was 93.1% and 90% respectively. Conclusion: Multi-slice CT can depict the imaging characteristics of carcinomas of pancreatic head and ampulla, and play an important role in pre-operative diagnosis and staging.
关键词
胰腺肿瘤 /
十二指肠肿瘤 /
体层摄影术 /
螺旋计算机
Key words
pancreatic neoplasms /
duodenal neoplasms /
tomography /
spiral computed
唐 平;滑炎卿;王 巍;殷于磊.
胰头癌和壶腹癌的多层螺旋CT诊断[J]. 中国临床医学影像杂志. 2007, 18(5): 311-314
TANG Ping;HUA Yan-qing;WANG Wei;YIN Yu-lei.
Diagnosis of carcinoma of pancreatic head and ampulla with multi-slice CT[J]. Journal of China Clinic Medical Imaging. 2007, 18(5): 311-314
中图分类号：
Ｒ735.9
Ｒ735.31
Ｒ814.42
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