论文部分内容阅读
目的:研究螺旋CT多期扫描技术在胰腺癌中的诊断价值及其临床意义。方法:68例胰腺癌患者行螺旋CT多期扫描,扫描时间为注射造影剂后18~25s、40~45s和60s左右,比较正常胰腺组织和肿瘤在平扫和三期的增强变化。依照CT征象诊断胰腺癌并行术前评估,并与手术结果比较。结果:正常胰腺组织在胰腺期的增强值明显高于其它两期(F=12.32,P<0.01);胰腺-病灶增强值胰腺期高于其它两期(F=15.11,P<0.01),肿块在胰腺期能够清晰显示。胰周血管在胰腺期显示满意,诸动脉在动脉期、胰腺期与门静脉期相比,有显著性差异(P<0.01);诸静脉在胰腺期、门静脉期与动脉期相比有显著性差异(P<0.01)。42例不可切除的肿瘤中,血管受侵者24例(57%),其中胰周小静脉扩张者19例(45%)。33例术前认为可切除的肿瘤,术中仍有7例不可切除。结论:螺旋CT三期扫描诊断胰腺癌,胰腺期和门静脉期应作为首选方案,它具有非常重要的临床意义。
Objective: To study the diagnostic value and clinical significance of multislice spiral CT in pancreatic cancer. Methods: Sixty-eight patients with pancreatic cancer underwent multislice spiral CT scan at 18 ~ 25s, 40 ~ 45s and 60s after injection of contrast agent. Compared with normal pancreatic tissues and tumors, the enhancement of plain and third stage pancreatic cancer were compared. Pancreatic cancer was diagnosed according to CT sign and was compared with the surgical results. Results: The enhancement of pancreatic tissue in normal pancreas was significantly higher than that in the other two stages (F = 12.32, P <0.01). Pancreatic-lesion enhancement was higher in pancreas than in other two stages (F = 15.11, P <0.01) In the pancreas can clearly show. The peripancreatic vessels showed satisfactory in the pancreas, the arteries showed significant difference in the arterial phase and the pancreas phase compared with the portal vein phase (P <0.01). There was a significant difference in the pancreas and portal venous phases between the arteries and the arterial phase (P <0.01). Of the 42 unresectable tumors, 24 (57%) had vascular invasion and 19 (45%) had peripancreatic venular dilatation. Thirty-three cases resectable tumors were considered preoperatively, and seven cases were still unresectable. Conclusion: The three-phase spiral CT scan in the diagnosis of pancreatic cancer, pancreatic and portal venous phase should be the first choice, it has a very important clinical significance.