多层螺旋ct扫描技术在胰腺癌诊断中的应用价值

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1、多层螺旋CT扫描技术在胰腺癌诊断中的应用价值【摘要】目的研究螺旋CT多期扫描技术在胰腺癌诊断中的临床应用价值。方法88例胰腺癌患者行螺旋CT多期扫描，扫描时间为注射造影剂后18～25s、40～45s和60s左右，比较正常胰腺组织和肿瘤在平扫和动脉期、胰腺期、门静脉期的增强变化。依照CT征象诊断胰腺癌并行术前评估，并与手术结果比较。结果正常胰腺组织在胰腺期的增强值明显高于其他两期(F=12.22,P<0.01);胰腺-病灶增强差值胰腺期高于其他两期(F=14.91,P<0.01)，肿块在胰腺期能够

2、清晰显示。胰周血管在胰腺期显示满意，诸动脉在动脉期、胰腺期与门静脉期相比，差异有显著性(P<0.01);诸静脉在胰腺期、门静脉期与动脉期相比差异有显著性(P<0.01)。55例不可切除的肿瘤中，血管受侵者32例(58.18%),其中胰周小静脉扩张者19例(34.54%)。40例术前认为可切除的肿瘤，术中仍有7例不可切除。结论多层螺旋CT双期扫描诊断胰腺癌，胰腺期和门静脉期应作为首选方案，具有非常重要的临床意义。【关键词】胰腺癌;X线计算机;体层摄影术;术前评估　　Abstract：Objecti

3、veToinvestigatetheclinicalvalueofmultislicespiralCT(MSCT)scanninginthediagnosisofpancreaticadenocarcinoma.Methods88patientswithpancreatic10adenocarcinomaunderwenttriple-phasespiralCTscanning18-25seconds,40-45secondsand60secondsaftertheinjectionofcontrastme

4、diumforangiography.Normalpancreatictissuesandthetumorwerecomparedbynormalscanningandtriple-phasespiralCTscanningsoastoexplorethevariationsinenhancedscanning.ThediagnosisofpancreatictumorwasbasedontheMSCTfindings,whichwereassessedpreoperativelyandlatercompa

5、redwiththesurgicalresults.ResultsDensitydifferenceofnormalpancreaswasgreatestonimagesobtainedinthepancreaticphase(F=12.22,P<0.01);meantumor-glandattenuationdifferencewasthegreatestonthoseobtainedinthepancreaticphase(F=14.91,P<0.01).Tumorandperipancre

6、aticvasculaturewerewellvisualizedinthepancreaticphase.Forvesselsdetection,sensitivityofarteriesobtainedinthearterialandpancreaticphaseswassuperiortothatofthoseobtainedinportalveinphase(P<0.01);sensitivityofveinsobtainedinpancreaticandhepaticphaseswasbet

7、terthanthatofthoseobtainedinarterialphase(P<0.01).Vascularinvasionof32casesweredetectedamong55unresectablecases(58.18%),ofwhich19caseswithexpansionofsmallveinsweredetected(34.54%).Of40caseswhichhadbeenpreoperativelydiagnosedasresectable,7caseswerenotres

8、ectableduringoperation.ConclusionInthe10diagnosisofpancreaticadenocarcinomabydual-phasespiralCT,pancreaticandportalveinphasesshouldbeselectedasthefirstscheme,whichhasveryimportantvalueinclinicalapplication.