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目的探讨64层螺旋CT对壶腹周围癌的诊断价值。方法采用64层螺旋CT对61例壶腹周围癌行平扫和动态增强扫描,对图像进行分析。首先判定肿块是否为胰头癌,再做出具体诊断,并与病理、手术对照。结果30例胰头癌CT诊断29例,无非胰头癌误诊为胰头癌。CT诊断与手术病理结果一致者56例(91.8%),不一致者3例(4.9%),未明确诊断者2例(3.3%)。胰头癌、壶腹癌、远端胆管癌及十二指肠癌均有较典型的CT征象,其诊断符合率分别为96.7%、88.9%、85.7%、83.3%。结论 64层螺旋CT及其三维后处理阴性法CT胰胆管造影技术对于壶腹周围癌的诊断有较高的准确性。
Objective To investigate the diagnostic value of 64-slice spiral CT in the diagnosis of periampullary carcinoma. Methods Totally 61 cases of periampullary carcinoma were scanned by plain scan and dynamic contrast enhancement with 64-slice spiral CT, and the images were analyzed. First determine whether the tumor is pancreatic cancer, and then make a specific diagnosis, and pathology, surgery control. Results 30 cases of pancreatic head CT scan in 29 cases, no non-pancreatic cancer misdiagnosed as pancreatic head cancer. 56 cases (91.8%) were diagnosed by CT, and 3 cases (4.9%) were inconsistent. There were 2 cases (3.3%) who were not diagnosed correctly. Pancreatic cancer, ampullary carcinoma, distal cholangiocarcinoma and duodenal cancer have typical CT signs. The diagnostic coincidence rates are 96.7%, 88.9%, 85.7% and 83.3% respectively. Conclusion 64-slice spiral CT and its three-dimensional post-operative negative CT cholangiopancreatography have a higher accuracy for the diagnosis of periampullary carcinoma.