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醫(yī)學免費論文:多層螺旋CT掃描技術在胰腺癌診斷中的應用價值
【摘要】 目的 研究螺旋CT多期掃描技術在胰腺癌診斷中的臨床應用價值。方法 88例胰腺癌患者行螺旋CT多期掃描，掃描時間為注射造影劑后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脈期、胰腺期、門靜脈期的增強變化。依照 CT征象診斷胰腺癌并行術前評估，并與手術結果比較。結果 正常胰腺組織在胰腺期的增強值明顯高于其他兩期 (F=12.22,P<0.01);胰腺-病灶增強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，諸動脈在動脈期、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%),其中胰周小靜脈擴張者19例(34.54%)。40例術前認為可切除的腫瘤，術中仍有7例不可切除。結論 多層螺旋CT雙期掃描診斷胰腺癌，胰腺期和門靜脈期應作為首選方案，具有非常重要的臨床意義。
【關鍵詞】 胰腺癌;X線計算機;體層攝影術;術前評估
The application value of multislice spiral CT scanning in the diagnosis
of pancreatic adenocarcinoma
WANG Huayu醫(yī).學.全.在.線zxtf.net.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.
