 |
 |
醫(yī)學(xué)免費(fèi)論文:多層螺旋CT掃描技術(shù)在胰腺癌診斷中的應(yīng)用價(jià)值
【摘要】 目的 研究螺旋CT多期掃描技術(shù)在胰腺癌診斷中的臨床應(yīng)用價(jià)值。方法 88例胰腺癌患者行螺旋CT多期掃描，掃描時(shí)間為注射造影劑后18～25 s、40～45 s和60 s左右，比較正常胰腺組織和腫瘤在平掃和動(dòng)脈期、胰腺期、門靜脈期的增強(qiáng)變化。依照 CT征象診斷胰腺癌并行術(shù)前評(píng)估，并與手術(shù)結(jié)果比較。結(jié)果 正常胰腺組織在胰腺期的增強(qiáng)值明顯高于其他兩期 (F=12.22,P<0.01);胰腺-病灶增強(qiáng)差值胰腺期高于其他兩期 (F=14.91,P<0.01)，腫塊在胰腺期能夠清晰顯示。胰周血管在胰腺期顯示滿意，諸動(dòng)脈在動(dòng)脈期、胰腺期與門靜脈期相比，差異有顯著性(P<0.01);諸靜脈在胰腺期、門靜脈期與動(dòng)脈期相比差異有顯著性(P<0.01)。55例不可切除的腫瘤中，血管受侵者32例(58.18%),其中胰周小靜脈擴(kuò)張者19例(34.54%)。40例術(shù)前認(rèn)為可切除的腫瘤，術(shù)中仍有7例不可切除。結(jié)論 多層螺旋CT雙期掃描診斷胰腺癌，胰腺期和門靜脈期應(yīng)作為首選方案，具有非常重要的臨床意義。
【關(guān)鍵詞】 胰腺癌;X線計(jì)算機(jī);體層攝影術(shù);術(shù)前評(píng)估
The application value of multislice spiral CT scanning in the diagnosis
of pancreatic adenocarcinoma
WANG Huayu醫(yī).學(xué).全.在.線gydjdsj.org.cn
(Department of Radiology, The First Affiliated Huai′an Hospital of Nanjing Medical University,
Huai′an, Jiangsu 223300, China)
Abstract： Objective To investigate the clinical value of multislice spiral CT (MSCT) scanning in the diagnosis of pancreatic adenocarcinoma. Methods 88 patients with pancreatic adenocarcinoma underwent triple-phase spiral CT scanning 18-25 seconds, 40-45 seconds and 60 seconds after the injection of contrast medium for angiography. Normal pancreatic tissues and the tumor were compared by normal scanning and triple-phase spiral CT scanning so as to explore the variations in enhanced scanning. The diagnosis of pancreatic tumor was based on the MSCT findings, which were assessed preoperatively and later compared with the surgical results. Results Density difference of normal pancreas was greatest on images obtained in the pancreatic phase (F=12.22,P<0.01); mean tumor-gland attenuation difference was the greatest on those obtained in the pancreatic phase (F=14.91,P<0.01). Tumor and peripancreatic vasculature were well visualized in the pancreatic phase. For vessels detection, sensitivity of arteries obtained in the arterial and pancreatic phases was superior to that of those obtained in portal vein phase (P<0.01); sensitivity of veins obtained in pancreatic and hepatic phases was better than that of those obtained in arterial phase (P<0.01). Vascular invasion of 32 cases were detected among 55 unresectable cases (58.18%), of which 19 cases with expansion of small veins were detected (34.54%). Of 40 cases which had been preoperatively diagnosed as resectable, 7 cases were not resectable during operation. Conclusion In the diagnosis of pancreatic adenocarcinoma by dual-phase spiral CT, pancreatic and portal vein phases should be selected as the first scheme, which has very important value in clinical application.
