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目的 探讨螺旋CT双期扫描技术及其对胰腺癌的诊断价值。方法 正常人 6 0例及胰腺癌 44例分两组行螺旋CT双期扫描 :A组 40例 ,分动脉期和门脉期 (注射对比剂后 2 0s和 6 0s)扫描 ;B组 6 4例 ,分胰腺期和肝脏期 (注射对比剂后 35s和 70s)扫描。分别测定各期胰腺、病灶及胰周大血管的CT值 ,计算胰腺期及肝脏期胰周小静脉的显示率 ,并行统计学处理 ,对扫描时相的比较采用方差分析及q检验处理 ,对胰周小静脉的显示率采用 χ2 检验分析。结果 正常组 ,胰腺在胰腺期的增强值高于其他 3期 (F =13 45 ,P <0 0 0 0 1)胰周大血管在胰腺期显示良好。胰周小静脉的显示率 ,胰腺期优于肝脏期 (χ2 =4 44 ,12 38,4 81,P <0 0 5 ) ;异常组 ,胰腺与病灶的增强差值 ,胰腺期明显大于其他 3期 (F =14 90 ,P <0 0 0 0 1) ,发现小胰腺癌 4例。胰周大血管受侵者占不可切除性肿瘤的5 4% (19/ 35 ) ,胰周小静脉迂曲扩张者占 42 % (10 / 2 4)。肝转移灶占 37% (13/ 35 )。结论 胰腺螺旋CT双期扫描宜分为胰腺期和肝脏期 ,该技术在胰腺癌的诊断中具有非常重要的临床价值。
Objective To investigate the dual-phase spiral CT scanning technique and its diagnostic value for pancreatic cancer. Methods Sixty normal subjects and 44 patients with pancreatic cancer were divided into two groups for two-phase spiral CT scan: 40 patients in group A were divided into arterial phase and portal phase (20s and 60s after contrast injection); group B 6 4 Cases were divided into pancreatic and hepatic phases (35s and 70s after contrast injection). The CT values of pancreas, lesions, and large pancreatic vasculature were measured at each stage. The display rates of pancreatic and hepatic peripancreatic venules were calculated. Statistical analysis was performed. The variance of the scan phase was analyzed by analysis of variance and q test. The peripancreatic venous display rate was analyzed using the χ2 test. Results In the normal group, the enhancement of the pancreas in the pancreas was higher than that in the other stages (F = 13 45, P < 0 0 0 1). The display rate of peripancreatic venules was better in the pancreas phase than in the liver phase (χ2 =4 44 ,12 38,4 81,P <0 05); the difference between the pancreas and lesions in the abnormal group was significantly greater than that in the other 3 During the period (F = 14 90, P <0 0 0 0 1), 4 cases of small pancreatic cancer were found. Peripheral pancreatic macrovascular involvement accounted for 5 4% (19/35) of unresectable tumors and 42% (10/24) of peripancreatic venous varicosity. Liver metastases accounted for 37% (13/35). Conclusions The pancreatic and hepatic phases of pancreatic spiral CT should be divided into two phases. This technique has very important clinical value in the diagnosis of pancreatic cancer.