螺旋CT在胰头癌可切除性评估中的价值

Value of helical computed tomography (HCT) in evaluating resectability of pancreatic head carcinoma.

目的 探讨螺旋CT判断胰头癌可切除性的方法和标准。方法 上海华东医院 2 0 0 2年 1月至 2 0 0 3年 9月使用螺旋CT对 18例胰头癌病人进行术前薄层多期扫描 ,将胰周血管受侵犯程度分为 4级 ,结合周围组织脏器的受累情况判断胰头癌的可切除性 ,并与手术结果相对照。结果 18例胰头癌病人 ,术前 9例判断可切除 ,实际 8例得到了根治性切除。准确率达 87 5 % ,不可切除的判断准确率达 90 %。结论 利用血管受侵犯程度分级 ,螺旋CT可以较准确的判断胰头癌的可切除性 ,具有重要的临床意义。

Objective To study the standard and methods of evaluating resectability of pancreatic head carcinoma by using helical computed tomography (HCT). Methods From Jan 2002 to Sep 2003,HCT scans were performed 18 patients with pancreatic head carcinoma. Thin section three-phase scans which consists of plain scans and arteri-vein scans were obtained by using contiguous 3-mm collimated slices. Peripancreatic vessels was prospectively graded on a 0-3 scale based on circumferential contiguity of tumor to vessel. Combining the degree of contiguous organ invasion together, the preoperative prediction of resectability of the tumor was made. Subsequent surgical results were then compared with the CT grades. Results Nine cases of 18 patients with pancreatic head carcinoma had potentially resectable tumors on the basis of CT.Eight cases received radical operation. The accuracy of resectability is 87.5% and the accuracy of unresectability is 90%. Conclusions Using CT grades of vascular invasion, the resectability of pancreatic head carcinoma can be evaluated exactly with HCT.HCT has important clinical value in evaluating resectability of pancreatic head carcinoma.