多层螺旋CT胰腺三期增强扫描的临床价值

Evaluation of Multislice Spiral CT Triple-phase Enhanced Scanning in Clinical Study of Pancreas

目的 探讨多层螺旋CT(MSCT)胰腺三期增强扫描的临床价值。资料与方法 随机选择 4 0例无胰腺疾病患者 ,进行平扫及三期 (动脉期、胰腺期及肝脏期 )增强扫描。分别测量平扫及三期增强扫描时胰腺实质密度 ,根据三期增强扫描胰腺实质密度较增强前提高程度 ,比较三期增强扫描胰腺实质强化的情况 ;同时分别评价动脉期与胰腺期胰周血管的显示率及显示程度 ,并行统计学分析。结果 三期增强扫描中 ,胰腺期胰腺实质密度较平扫提高程度最为明显 ,胰腺期与动脉期及胰腺期与肝脏期 ,差异均非常显著 (P <0 .0 0 1)。对于胰周大动脉显示率 ,动脉期与胰腺期无统计学差异 (P >0 .0 5 ) ,而对其显示程度 ,则差异非常显著 ,动脉期明显优于胰腺期 (P <0 .0 0 1) ;对于胰周大静脉、胰周主要动、静脉的显示率及显示程度 ,动脉期与胰腺期则均有显著性差异 (P <0 .0 1)。结论 MSCT胰腺检查 ,一般宜行三期增强扫描 :动脉期、胰腺期及肝脏期 ;若已于MSCT检查前明确为不可切除性胰腺癌 ,亦可行双期增强扫描 :胰腺期及肝脏期。

Objective To discuss the clinical application of multislice spiral CT (MSCT) triple-phase enhanced scanning of pancreas. Materials and Methods Both plain and triple-phase (i.e. arterial, pancreatic and hepatic phase) enhanced CT scanning were performed in randomly-selected 40 subjects without pancreatic disease. CT values of pancreatic parenchyma were measured. The elevated CT values of pancreatic parenchyma after enhancement were estimated and compared between the three phases. The displaying rate and degree of peri-pancreatic vessels at both arterial and pancreatic phase were separately evaluated, The results were statistically analyzed.Results The increase of CT value was the biggest in pancreatic phase. Significant difference in the increase of CT value existed between pancreatic and arterial, as well as between pancreatic and hepatic, phase (P<0.001). The displaying rate of larger peri-pancreatic arteries was of no difference between arterial and pancreatic phase (P> 0.05), while arterial phase was well superior to pancreatic phase in the displaying degree of the peri-pancreatic vessels (P< 0.001). Significant difference in the opacification and degree of peri-pancreatic large veins, the major arteries and veins was also existed between arterial phase and pancreatic phase (P<0.01).Conclusion When MSCT is used in the exam of pancreas, triple-phase enhanced scanning is the optimal selection. Dual-phase scanning is also suitable for patients whose lesion has been proved to be not resectable.