目的探讨MSCT动态增强扫描在壶腹周围癌诊断中的应用。方法收集我院2008-03-01-2009-10-01共20例有病理结果的壶腹周围癌患者,其中胰头癌11例,壶腹癌4例,末端胆管癌5例,对比分析病变特征性影像特点。结果胰头癌中,绝大多数病灶平扫及增强扫描均呈低密度,边界不清,其中有1例胰头癌病变强化较明显,经病理证实为神经内分泌型胰腺癌,半数以上有胰体、尾部的萎缩,均可见“双管征”;末端胆管癌中,胆总管管壁不均匀增厚,部分可见结节影,平扫程等密度,增强扫描强化较明显,部分病例可见延迟强化,肝内、外胆管扩张较重;壶腹癌中,病灶呈圆形等密度结节,边缘较规则,强化程度高于胰头癌,低于胆总管癌,胆管全程扩张,可见“双管征”。结论MSCT动态增强扫描在壶腹区恶性占位性病变疾病诊断中有重要作用。 Objective To investigate the application of dynamic enhanced MSCT in the diagnosis of periampullary carcinoma. Methods Totally 20 patients with ampullary carcinoma who had pathological results were collected in our hospital from March 2008 to January 2009. There were 11 cases of pancreatic head cancer, 4 cases of ampulla carcinoma and 5 cases of terminal cholangiocarcinoma. The pathological changes Characteristic image features. Results In pancreatic carcinoma, most of the lesion showed low density and unclear boundary. Among them, one case of pancreatic head carcinoma showed more obvious lesion enhancement, and pathologically proved to be neuroendocrine pancreatic cancer. More than half had pancreatic cancer Body, tail atrophy, are visible “double tube sign ”; end of cholangiocarcinoma, common bile duct wall uneven thickening, nodules can be seen in part, plain scan density, enhanced scan enhancement more obvious, in some cases Can be seen delayed enhancement, intrahepatic and extrahepatic bile ducts dilatation heavier; ampullary carcinoma, the lesion was circular and equal density nodules, the edge of the rule, the degree of enhancement higher than the pancreatic cancer, lower than the common bile duct cancer, bile duct full expansion, visible “Double sign”. Conclusions MSCT dynamic contrast-enhanced scan plays an important role in the diagnosis of malignant space-occupying lesions in ampulla.