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目的 探讨胆胰管十二指肠连接区小肿瘤的CT诊断及其鉴别点 ,提高CT诊断的敏感性和准确性。材料与方法 连接区小癌 2 2例 ,包括胰头癌 12例 (其中 6例位于胰钩突 ) ,Vater’s壶腹癌 5例 ,胆总管下端癌 5例 ;另胰头区炎症 5例 ,以作对照分析。全部病例均经手术病理证实。结果 (1)连接区小癌CT表现为胰头或钩突增大变形、密度改变及十二指肠内侧壁结节 ,胆总管壁增厚或下端结节 ;胰头癌突出表现为低密度区 ;Vater’s壶腹癌、胆总管下端癌密度相对高 ,这与肿瘤的病理结构有关 ;大部分病例有胰胆管扩张 ,胰胆管扩张与否依据肿瘤生长的位置而定。(2 )胰头区炎症亦表现胰头增大 ,胰胆管扩张 ,但胰头密度均匀 ,与周围结构分界不清 ,胆道积气 ,这些可作为与肿瘤的鉴别点。结论 连接区小癌的CT诊断及鉴别虽然还有一定的困难 ,但其仍不失为一种有效的诊断方法
Objective To investigate the CT diagnosis and distinguishing points of small tumors in the duodenal connective area of cholangiopancreatic duct and improve the sensitivity and accuracy of CT diagnosis. Materials and Methods There were 22 cases of small cancers in the connected area, including 12 cases of pancreatic head cancer (6 of them were located in the pancreas of the pancreas), Vater’s ampullary carcinoma in 5 cases, and common bile duct cancer in 5 cases; another pancreatic head area inflammation in 5 cases. For comparative analysis. All cases were confirmed by pathology. RESULTS: (1) CT of the small area of connective area showed enlarged or distorted pancreatic head or uncinate process, density change and duodenal internal wall nodule, common bile duct wall thickening or inferior end tuberculosis; Density area; Vater’s ampullary carcinoma, relatively high density of the lower common bile duct, which is related to the pathological structure of the tumor; in most cases there is expansion of the pancreatic duct, pancreaticobiliary duct expansion depends on the location of the tumor growth. (2) The pancreatic head area inflammation also shows an increase in the size of the pancreatic head, dilatation of the pancreatic bile duct, but the density of the pancreatic head is uniform, the boundary with the surrounding structure is unclear, and biliary tract gas, which can be used as a distinguishing point from the tumor. Conclusion Although there are still some difficulties in the diagnosis and differential diagnosis of small cancer in the connected area, it is still an effective diagnostic method.